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Home My WebLink AboutBLDE-22-007297 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-007297 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 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:6/21/2022 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) 205 OLD MAIN ST Owner or Tenant ST DAVIDS EPISCOPAL CHURCH Telephone No. Owner's Address 205 OLD MAIN ST, SOUTH YARMOUTH, MA 02664-4529 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 ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install two split NC units in Day Care area. 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. 2 Total No.of Alerting Devices Tons 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 ❑ Municipal ❑ 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: $80.00 Commonivea[/ of maddach.th Official Use Only "Et c� '7 1"�' ' � s/var�nunf o�.}i+v,�iwrcd Permit No, �z� (7 I i 71 Occupancy and Fee Checked v BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07] � (leave blank) l` APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: -. /-7 -- 2 0 2 2 City or Town of: t By this application the undersigned his or her orTH ention to perform the electrical wo e or of Wires: described below. �J Location(Street&Number) pi( s 0 C /y-l 4/yi ✓ j �s�,t�v , ' Owner or Tenant all/)r f4 L f � e+� i t C a 1,4/ 'iivaelephone o. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No Purpose of Building1.0{ re (Check Appropriate Box) 0 u crttais Ale_ Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: tit)/ ej.-- a, dz.( e 3 5" 11-.I C. * Completion of the following table may be waived by the In vector of Wires, t1F, No.of Recessed Luminaires No.of Cell:Scrap.(Paddle)Fans No.of Total 0� Transformers KVA 'Z No.of Luminaire Outlets No.of Hot Tubs Generators KVA mot:' No.of Luminaires • Swimming Pool Above ❑ In- No.of Emergency Lighting ernd. grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones ,` No.of Switches No.of Gas Burners No.of Detection and t;r Initiating Devices No.of Ranges No.o�Air Cond.v. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons 1KW 4No.of Self-Contained Totals:I f Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal n 0 �� No.of Dryers Heating Appliances KW Security Systems:* o No.of Water KW No.of No.of Devices or Equivalent HeatersNo.of Data WIring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E uivalent 1 ✓ Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: G Work to Start: �[ (When required by municipal policy.)'2b Z�Inspections 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 1 (, , - I certify,under the pains had penalties o ❑ (Specify: fpedury,that the informed n on this eppl'anon is true and complete. , tr - /(/ FIRM NAME: Licensee: LIC.NO.: i! 'F i (lf applicable,enter"exempt"in the license number line.) Signature LIC.NO.: Address: Bus.Tel.No.: )1 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safe 5"License: Alt.TeL No.: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature one below,I hereby waive this requirement. I am the(check Owner/Agent • owner • owner's aeent. Signature Telephone No. PERMIT FEE:$