HomeMy WebLinkAboutBLDE-19-006368 . •... Commonwealth of
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Massachusetts Permit No. BLDL 19 0O 36n
BOARD OF FIRE PREVENTION REGULATIONS Occupancy:nul Fee Checl:,.)(1
[Rev.U071
APPLICATION FOR PERMIT TO PERFORM�EL E C f-_'AL WORK
All work to be performed in accordance with the Massachusetts Electricai Code (N11:(1:),ssri.7i.;`,1IZ 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:5/10/2019
City or Town of: YARMOUTH To ibe h,,,p,rou-r,/I Fire:
By this application the undersigned gives notice of his or her intention to perform the electrical wo• described below
Location(Street&Number) 33 CREST CIR 'em�- ` A '
Owner or Tenant WALSH MARGARET R(EST OF) I'ei me No 0.:111111fieW
Owner's Address C/O NANCY GULLBRANTS, 45 CAMBO ST, BROCKTON, MA 02401-585
Is this permit in conjunction with a building permit? Yes ❑ No L _ "p)rla . III/yip
I
Purpose of Building
Utility Aatlmr(rit(on No.
Alor
Existing Service Amps Volts Overhead ❑ Und,-r:! o. ir fir
New Service Amps Volts Overhead ❑ Umb4ri C, ;,-
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Swimming pool.
___._.
Completion n/d u lo rl1n rr ;l r r rn he waived h( the Inspectoo of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans TN0.of Total
No.of Luminaire Outlets No.of Hot Tubs Geocrator KVA
No.of Luminaires Swimming Pool rnd.Above '❑ g ❑ No. r 1 i i'"' "''' Lighting
grnd. ttery
No.of Receptacle Outlets No.of Oil Burners I F1 rf A 1,i( (S fN0.of Zones
No.of Switches No.of Gas Burners `o ref 1)el<cr;o;; .u(d
Ilni i iyil(;! H c v c;1
No.of Ranges No.of Air Cond. Total , i .rU( (vs ices
Tons
No.of Waste Disposers Heat Pump Number Tons k\l ��„ I it iucd
Totals: !R , n' ,i Devices
No.of Dishwashers Space/Area Heating KW (,, (_; "�t Sal 0 Other:
i ection
No.of Dryers Heating Appliances KW i`y S ( s:
IN )0 Equivalent
No.of Water KW No.of No.of !Iota
Heaters Signs Ballasts
„I ,°, of r)ev or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP j i; tr omm I Bons Wiring:
OTHER: ——
z... f pee a y s r Equivalent
1iletilr /l,ro,r enriiu r f z,1 or(IS regtrircrihi'thelriapeCor ofirires.
Estimated Value of Electrical Work: (When required by muni ll , , )
Work to start: Inspection to be requested in accordance with rASEC RI,i: 10, v i,ip in ,;,'dill.
INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of elecli i-;;l o i e .;,';,the lieenscc
provides proof of liability insurance including"completed operation"coverage or its substantial equivaL:nt "I-' :: ,;;, Iris ,ccrtiHes than 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 r,r;r/;nrrrnrr ie.
FIRM NAME: Neil Schoener
Licensee: Neil Schoener Signature
I applicable, i,iC-.i�0.: 13949
(.f pp ' able,enter"exempt"in the license number line.) —�-
Address:44 TRADERS LN, W YARMOUTH MA 026733333 ii,..
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 insurerike C(,\. ,'' i; ,
signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 ()%v t, , , qll lied by law. Bun
Owner/Agent
Signature Telephone No. —
_ �' ornmorsrusaCfh o� assaciucsafts Official Use Only
."/ Services
Permit No. 9-- 4j�j(p 8
eft= cPart-mad o f ire S J
BOARD OF FIRE PREVENTION REGULATIONS i Ov p and Fee Checked
—
et`l cave blank) —
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: 5 ) 0 _-IR
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the pndersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street&Nu r) T. ' r- 5 r t fad /A 4441
94
Owner or Tenant '}-k _- . A- 44 -c•- Telephone No.
Owner's Address
Is this permit in conjun tion with a building pit? Yes — No
El Purpose of BuiIdinj�L fi►�s►1 ry (Check Appropriate Box)
Utility Authorization No.
Existing Service Amps / Volts Overhead
[I] E No.of Meters
New Service Amps / Volts Overhead
❑ Undgrd No,of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: INL re,/ (5`00 1'
Lori Lti�/ cov-e-r" h0 0
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 -
EMI Ertl
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 _
Tons No,of Alerting Devices
No.of Waste Disposers Heat Pump Number `Tons H KW No.of Self-Contained
Totals: 1 Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW' Municipal _
Local Et ❑ ��
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.ofNo.of Devices or Equivalent
Heaters KW No. of Data Wiring:
Signs Ballasts No.of Devices or Equivalent
No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
I; OTHER: No.of Devices or Equivalent
Estimated Value of Electrical Work .�Attach additional detail if desired or as required by the Inspector of Wires.
: C20e1
p (When required by municipal policy.)
Work to Start:$ -t O -( 1 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless wai ed by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability i ce including"completed operation"coverage or its substantial equivalent, The
4 undersigned certifies that such cove e is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:)
I certify, under the pains d penalties of ry,that the information on this application is true and complete.
FIRM NAME: p t l C� _
,,...._,
Licensee: Si nature LIC.NO.: /¢__ g y9
(If applicable, enter' g LIC.NO.: /
&ns crumb r!i e.) --��_
. Address sT l' i,he1.4 Bus.Tel.No.:
t Per M.G.L. c. 147 s_57-6I,security work requires )]apartment of blic Safe Alt.Tel.No.: �1 V E)
OWNER'S INSURANCE WAVER: I am aware that the Licensee does not have the liability insurance coverage normally—
S required by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner ❑owner's agent
Owner/Agent
Signature Telephone No. I PERMIT FEE: $ I