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Home My WebLink AboutBLDE-23-002877 -- • t� Commonwealth of Official Use Only ' �. ' Massachusetts Permit No. BLDE-23-002877 • BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 1 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) City or Town of: YARMOUTH Date:the Inspector of Wires: 2 By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 383 ROUTE 28 Owner or Tenant W YARM CONGREGATIONAL CHURCH Owner's Address 383 ROUTE 28, WEST YARMOUTH, MA 02673 Telephone No. Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate o Purpose of Building / Utility Authorization No. `Existing Service Amps Volts Overhead 0 t ' J / New Service Undgrd ❑ No.of Meters , Amps Volts Overhead 0 Undgrd 0 p // - Number of Feeders and Ampacity gNo.of Meters Location and Nature of Proposed Electrical Work: Upgrade excterior lighting&emergency lights. 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 Transformers Total KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires 5 Swimming Pool gr bovend. ❑ g rnd. ❑ No.of Emergency Lighting 3 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges Initiating Devices No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: No.of Dryers Connection Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW Sig o No.of Ballasts Data Wiring: He tern Hydromassage Bathtubs s No.of Devices or Equivalent No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. (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 :) I certify, f pI,under the pains and penalties o er u that the information on this application istrue and complete. FIRM NAME: NEIL SCHOENER Licensee: Neil Schoener Signature LIC.NO.: 13949 (If applicable,enter"exempt"in the license number line.) Address:44 TRADERS LN, W YARMOUTH MA 026733333 Bus.Tel.No.: *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 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: $80.00 I ) RECEIVED i '' t CV 2 3 2C2 e eaith o11//a4aachuaafla Official Use Only 1,1/4 4x a,1- a c� Permit No. 7leavel'bia::- 7 t pint"!o cro orviced., , DING CEPA4:TIviEPvfi._BOARD OEEIRE_$REVENTION REGULATIONS Ov. 1/07]y e C' jRev, l/07] v APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M ),527 C R 12.00 I•, (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1 !�Z.3 �_c>� Z City or Town of: YARMOUTH To the Inspector of ires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 3 j Owner or Tenant (/1! T 6y1G'c---��f C a'.1 4x ' �',, e vl Owner's Address �) �� '�'� Telephone No. ' Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building � P(ut� lie l 2cY. ��,I t L t Utility Authorization No. i Existing Service Amps / Volts OverheadU ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: let?PI y c- q -N e t5 . Lu4,4(1 ((9 1,,(-s ec,Jr !'ul bt 1-� os 1? -e PIt kr, 3e �u:-�� w �r�� c, (t [t.)Ltt,t `.i Completion of the following table may be waived by the In ector of Wires. !!,a No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers No.of Luminaire Outlets KVA No.of Hot Tubs Generators KVA ,t No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grad. grad. ❑ Battery Units a No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners 'No.of Detection and IQ No.of Ranges Dotal Initiating Devices g No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers 'Heat Pump Ni tuber• Tons Tar 'No.of Self-Contained Totals:1 I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW gecurity Systems:* No.of Water No.of No.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: OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work. / 5 0 U' (When required by municipal policy.) Work to Start: I(I 2 t 12o a L 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 iss the licensee provides proof of liability iiI.urance including"completed operation"coverage or its substantial equivalent.unTThless undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE EISY BOND 0 OTHER 0 (S ci I certify,under the pains and penalties operjury, ) jthat the information on this application is true and complete.FIRM NAME: /V e ; I.- 5 c kc L-tp Licensee: /' LIC.NO.: , -(3�'� Signature Li' tiy_-- LIC.NO.: (If applicable,enter:'exempt"in the license,number linpe�.)� Address: 41 LS I ro L i, (mow tN1<)1 y 612.4.1e:4-4 Bus.Tel.No. j � *Per M.G.L.c. 147,s.57-61,security work requires Departfnent of Public Safety Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n�� required by law. By my signature below,I hereby waive this requirement. I am the(check one / owner • owner's a ent. Owner/Agent Signature Telephone No. p PERMIT FEE:$