The URL can be used to link to this page

Home My WebLink AboutBLDE-22-007194 Commonwealth of Official Use Only Permit No. BLDE-22-007194 4 ,,� Massachusetts ...;,0 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:6/14/2022 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) 38 HIALEAH AVE Owner or Tenant FORRISTER LOREN Telephone No. Owner's Address FORRISTER KATHLEEN P, 157 LEONARD RD, DUMMERSTON,VT 05301 .. , 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 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters - Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 30 amp circuit for water heater. 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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons 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 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water 1 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 ( RECEIVED ! 2114 022(�o ins nwsa/h o�Maaeachivast d Official Use Only - �. " iN13 ,leave .� -�CtnPermit No, Z-� B .��._ ►+ w ` :_.._.-. __ _ . .___.. sln tinsnE o1 3irs Jiwicsd ) I(M=;; DING DEPARTMENTOccupancy aChecked �, ,''_ ABOARD OF FIRE REVENTION REGULATIONS [Rev. 1/07] lank )7( (---( l� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK P` 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: -/ 3 •- 7-0 7 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. Location(Street&Number) 3 ; if /�r (.. ' . /, „: (,i(,� ) ytyr&.wtic; Owner or Tenant L_,O, e/) /%,-r-e. s •---� _jelephone No. Owner's Address y • Is this permit in conjunction with a building permit? /_ Yes ❑ No [-j (Check Appropriate Box) Purpose of Building ..i��,ryf , jfl i dee' Mtlkle---. Utility Authorization No. Existing Service /O(i Amps /Zej / 2 Volts Overhead❑ Undgrd❑ No.of Meters / 1 New Service Amps / Volts Overhead El Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: t ,t.,,,l d' iW e .;7fer lfZT IA/6k t--r" Completion of the followingjle mab be waived by the In vector of Wires. ti;� No.off Total i,jc No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans r,/ Transformers KVA 1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA r 4'. No.of Luminaires SwimmingAbove In- No.of Emergency Lighting Pool grnd. ❑ grnd. ❑ Battery Units 1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and v. Initiating Devices I..r No.of Ranges No.oe Air Cond. Total No.of AlertingDevices 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❑ Monne�tiunicipalon 0 C No.of Dryers Heating Appliances KW SricNo o Systems:* Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring. No.of Devices or Equivalent OTHER: Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: �7 00 ~-' (When required by municipal policy.) Work to Start: (s---/3 .k 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 i ranee including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. j/ FIRM NAME: c iL- S 'CAi 0 C.1 e ,- LIC.NO.: Licensee: Signature ', ,®- _ LIC.NO.: (lfapplicable,after,"exempt"in the license nambe lined us.Tel.No.: L Address: 4-1 n-N It vZ)i dt ivia-04t4_�d ))Alt.Tel.No.: :7(1e*7?1r /its 7 *Per M.G.L.c. 147,s.57-61,security work requires Departm t of Public Safety"S"License: 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 below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$