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Home My WebLink AboutBLDE-19-002920 Commonwealth of Official Use Only le . , Massachusetts Permit No. BLDE-19-002920 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev.1/07 .A\ APPLICATION FOR PERMIT TO PERFORM EL rep WOR All work to be performed in accordance with the Massachusetts Electrical Code (1 C•*.1 4 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:11/13/20j�11. 3 _ City or Town of: YARMOUTH To th Inspector of'Wire v �!] I`r i By this application the undersigned gives no ice o is orher in en ion o perform a wor decr' ed elow. —� �' Location(Street&Number) 33 CREST CIR Owner or Tenant W T OF) Telephone No. Owner's Address /O N S, 401-5862 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead ID Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Rough wiring for residence. Completion of the,following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Neil Schoener Licensee: Neil Schoener Signature LIC.NO.: 13949 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:44 TRADERS LN,W YARMOUTH MA 026733333 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $50.00 ets.o.r.ii- "1114119 -,'t _ Coma onr°san.4 •1a achu _ —_— Official Use Only _ t —" aparfincnt al Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ,r•' v. 1/07] my,blank — •APPLICATION FOR:'PERMIT TO PERFORM ELECTRICAL All work to be performed in accordance with the Massachusetts Electrical CodeAll R K (PLEASE PRINT IN INK OR TYPE ALL INFO (MEC),527 —/ l 2.D0 INFORMATION) Date: j 1_ 13 I b City or Town of: ARMOUTH By this application the undersigned To the Inspector of Wires.• gn gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) 3 Owner o (Street CC � w` Q'Z�G+M� Owner's Address TeleFh ne No. Is this permit in conjunction with a building permit? Yes Purpose of Building /u P,(,J r17JU.S2. N0 (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead Q Undgrd 0 No.of Meters New Service Amps / Volts Overhead El Undgrd 0 No,of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work; 0 U llY/ CoinCom letion a the ollowin table m be waived the Inr ector o Wires. No.of Recessed Luminaires No.of CeR.-S usp.(Paddle)Fans °•°f Total No. of LIIminaire Outlets No. Transformers KVA of Hot Tubs Generators No.of Luminaires KVA Swimming Pool Above In.. o,o mergency tang_rnd. ornd. Bane Units No.of Receptacle Outlets No.of Oil Burners No.of Switches FIRE ALARMS No.of Gas Burners o.of Detection and No.of Ranges Iaitiatin Devices No. of Air Cond. • No.of Waste Disposers Tons No.of Alerting Devices Heat Pump umber Tons Totals: --- a of elf ontai No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW Local ri Municipal No.of Dryers Connection Other Heating Appliances KW Security Systems:* No.of ater No.of Devices or E ii uivalent Heaters KW No,o o.of Si s Ballasts Data Wiring: No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or uivalent Estimated Value of Electrical Work ✓ .- 61iv Attach additional detail ifdesired or as req uired by the Inspector of Wires. (296 Work to Start: i t 3 g Inspections t (When required by municipal policy.) INSURANCE CO e requested in accordance with MEC Rule 10,and upon completion. RA E: Unless wai by the owner,no the licensee provides proof of liability including permit for the performance of electrical work may undersigned certifies that such cove ty e is in force,and has exhibited pcompleted rperation"roof of same tothee oritst substantial o ce.equivalente The CHECK ONE: INSURANCEP suing office. I certtfy, under the pains and en BOND [] OTHER � (Specify.) FIRM NAME: allies°fPerjury, at the information on this application is true and complete.) C, o t�ler- a� Licensee: LIC.NO.: /, itt[ (If applicable.ent�rr empt' th 1' a Signature • Address: 7 `�� J�er tin / LIC.NO.: .I "Per M.G.L.c. 147,s.57-61,securityi `\/ Gt.1 at nio Bus.Tel.No.: �— OWNER S INSURANCE work requires Department of blic SafetyAlt.Tel.No.: 8C7 required by law. g NCE WAIVER: I "S"License: Lic.No. am aware that the Licensee does not have the liability insurance covera�o� S Owner/Agent Y y signature below,I hereby waive this requirement. I am the(check one 0 SignatureB nortnally ai owner ❑owner's a ent Telephone No. PERMIT FEE: $