HomeMy WebLinkAboutBLDE-22-000822 Commonwealth of Official Use Only
I. ` Massachusetts Permit No. BLDE-22-000822
` BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.1/07]
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 GMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:8/13/2021
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) 5 NEW HAMPSHIRE AVE
Owner or Tenant Shrinath Narahari Telephone No. �,,,Cf `
Owner's Address `�� Pie`
Is this permit in conjunction with a building permit? Yes CI No 0 , "A`�'
Purpose of Building Utility Authorization
Existing Service Amps Volts Overhead 0 Undgrd .= :--'rs
New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: New 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
Initiative Devices
No.of Ranges No.of Air Cond. To
No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local ❑ 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 Siens 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 p Telephone No. PERMIT FEE: $180.00
i2wsti f 9gratilt,
/.172,1 ...... '
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BOARD OF FIRE Occupancy and Fee Checked
_ PREVENTION REGULATIONS [tev.1i07j vane wank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be pafonned in acoonance with the Massachusetts Hectcical Code 527 QNR 12.00
4 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date;
By of: YARMOUTH To the Inspector ir ��
undersigned this application the give- orNor her or ofWires:
Location(Street&Number) �/' to �" � „�decided work d�'bed behove. L.
Owner or Tenant 5- H A ' e�r�q
Owner's Address
v Y a.�G ha fr.",` Telephone No.
Is this permit in conjunetbn prith a building p ? Yes
Utility Authorization Na t fl 171• 2 C>
Exislin Service Amps / Volts Overhead 0 Uadgrd❑ of Meters
'�- New Se vice 2 ) Amps ' Volts OverheadII
� L ��� 0 udgrd No.of Meters
Number of Feeders and Anytacity
Location and Nature of Proposed Electrical Work //0 I, . A)&J 4I u4G i
CM 1).1--r' ..i' Oliv,e2 Se___,'to,
No.of CeL Snap,f�Pada) �Na tabk may be waived
�the 1, ,of woes.
th No.of Recessed 'Total
No.ti
CI of I Outlet. Transfornims KVA
No.of Hot Tabs Generators KVA
# No.of I.uminal,es Swimming Pool Above 0 la- 0 No.of II cy
No.of Oats No.of 00 INo.of
Burners
� RI1tE ALARMS Zoaca
�" 'of No.of Burners bdliating Devices
No.of Detection and
t L1 No.of Ranges No.ofAir Coed. Total
No.of Waste Aeat . ,Tons No.of Alerting Devices
Totds:1 er(Teas [ifw N Devices
No.of�rrashe rs Space/Area Heating KW 1 Load 0 ❑tom.
No.of Dryers Heating AppRuces KW 'RS' .4
No.of W KW Data
'No.of No.of a it or Equivalent
Heaters
Slims Ballasts
No.ofDevices or EqMvalent
No.Hydromassage Bathtubs No.of Motors Total HP T tbm W
-OTHER: No.of Devices or Bq��
Estimated Value of 1 Work tJ c,.. /Waab ari barest detail 3fdesined or as by the taped.of t1 i es.
Work to Start 8— -2- (When required by municipal policy.)
INSURANCE COVERAGE: Unlessested in sceonlaoce with MEC Rule 10,and upon diction.
the INSURANCE
E des woofer liability•
by owner,n o permit for the of electrical work may issue unless
undersigned that such covoperation"ding"completed coverage er its substantial equivalent The
�ONE: is in�+and has proof of same to the permit issuing office.
Ir INSURANCE BOND 0 OTHER 0 (Spur,)
Iea NAME: Aid.
,the pains �f d y,that the�n this 1s tare and a j`Q'
LIC NO: /�"1 �7 /
Licensee:
t '� I LIC.NO:
Addreu: a� a � Q GM 1lid-1247 uo.TeL No: I i?�
*Per MAIL.c.147.s.57-61,security work Alf:Tel.No.• /O
OWNER'S INSURANCE WAIVER: I am awarethat the Licensee nof Public ot
havea the
L1O8° Lin. c r`
required by law. By my signature below.I hereby waive does>I am (checkliabilitya insurance coverage nomtaliy
ceAgentaqputu Wit. I the one /owner owner's
Telephone No. PERMIT FEE:$