HomeMy WebLinkAboutBLDE-23-002150 _ Commonwealth of Official Use Only
€ " ' Massachusetts Permit No. BLDE-23-002150
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.1/071
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:10/21/2022
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 50 TRADERS LN
Owner or Tenant DON AMADO Telephone No.
Owner's Address 50 TRADERS LN,WEST YARMOUTH, MA 02673
Is this permit in conjunction with a building permit? Yes ❑ No 0 ��Box) ^ � �'?1 0_
Purpose of Building Utility Authorization No i< ("ji+, 4�"
Existing Service Amps Volts Overhead 0 Undgrd 0 �� � 'o.o s ete Ni rk
____—
New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Replacement meter socket.
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- ElNo.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. Ton l No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
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 Ballasts Data Wiring:
Heaters Signs 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 Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License:
OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But my
signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$50.00
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giro Je Permit No. 3-2�9)
4— ' a'``;; BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 1/07] (leave blank) ---
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
�� All work to be performed in accordance with the Massachusetts Electrical Code( EC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Q - 2-/— 7-0 2 2
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
c' Location(Street&Number)
`0'12 tA'[7 2S 1 t;- (A-CS7: ✓f,2 rv1U f
Owner or Tenant Q in 0
Owner's Address Telephone No.
Is this permit in conjun ion with a building permit? Yes ❑ No
Purpose of Building ��Q (Check Appropriate Box)
'f M rg 0 cZct''Utility A rizadon No. Jo 4 q s-?Co'il Existing Service�Q Amps / 2y0 Volts Overhead Undgrd g ❑ No.of Meters
New Service Amps /__Volts Overhead
N Number of Feeders and Ampadty El Undgrd 0 No.of Meters
Location and Nature of Proposed Electrical Work: ae_e__ �iJl�
.5 a C Zers
���� �pL Ot/Z1—/�ca®e
vi
o'era Com letion o the ollowin table m be waived b the In ctor o Wires.
- No.of Recessed Luminaires
No.of Ceii:S°sp.(Paddle)Fans 0.0 ota
'�;t No.of Luminaire Outlets Transformers KVA
r�‘ No.of Hot Tubs Generators KVA
A No.of Luminaires Swimming Pool ove ❑ n- o.oe mergency g ng nd. ❑ Batte Units g
No.of Receptacle Outlets
No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners
o.o etec on an
4' No.of Ranges Initiatin Devices
No.of Air Conti.
Tonotas No.of Alerting Devices
No.of Waste Disposers eat ump um er ors
Totals: ...._ _...._._.. o.o e - onta ne
No.of Dishwashers ....... Detection/Alertin Devices
Space/Area Heating KW Local un crpt i a
No.of Dryers Heating Appliances KW ecu ty C ystems: 0 ��
o.o a er No.of Devices or E uivalent
Heaters o'° °•° Data Wiring:
Si fix Ballasts No.of Devices or E uivalent
No.Hydromassage Bathtubs No.of Motors a ecommun ea ors r g
Total HP No.of Devices or E uivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: l�(,
(Work to Stan: �r7-Ll-Zo22 (Whenrequired by municipal policy.)
Inspections to equested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waiv y the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability i rance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such cove e is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND
I certify,under the pains and ❑ OTHER 0 (Specify:)
FIRM NAME. penalties ofperjury,t at the information on this application is true and complete.
Baal A e,` L- Soho cove-e.— •
Licensee: LIC.NO.: q�9
(lfapplicable,enter'e ^in Signature � � LIC.NO.:-r
Address: L prs�n tuber line.), /
*Per M.G.L.c. 147,s.57-61,security work requires De s iv Bus.Tel.No.
OWNSOWNER'S INSURANCE WAIVER: I am aware that doof les Safetyot have the liabilityinsurance.TeL No.: `�,�?
bylaw. By "S"License: Lic.No.
requir
my signature below,I hereby waive this requirement. I am the(check one •
coverage normally
o __
Owner/Agent
la
Signature ■ owner ■ owner's a:ent.
Telephone No. PERMIT FEE:$