HomeMy WebLinkAboutBLDE-23-002878 .6 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE 23 002878
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.1/071
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:11/23/2022
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) 7 BRUSH HILL RD
Owner or Tenant GARCIA MICHAEL R Telephon•Nn
Owner's Address CORBEAU DIANNE, 7 BRUSH HILL RD,YARMOUTH PORT, MA 02675
kEi?'" AO
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) -i) r�
Purpose of Building Utility Authorizat 'n No. 11243785 /� JJ��
Existing Service 100 Amps Volts Overhead 0 Undgrd No.of Meters '!'
New Service 200 Amps Volts Overhead 0 Undgrd 0 ► !.of M s
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Upgrade service&wire for generator
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. 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 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 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
Q At (7_3k
RECEIVED
`1. n Official Use Only
-_. V 2 3 2012 a I nw.a a/ Official 7 g78
q-_., c7 Permit No.
7 a ' _ parlm.ni 4Jim�.rvic s
G DEPARTMENT Occupancy and Fee Checked
_�. :S_E,• . PREVENTION PREVENTION REGULATIONS [Rev,1/07] (l blank)
4< APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
T All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
' (PLEASE PRINT IN INK OR TYPE ALL INFORMATTONI Date: )I- 'Z 3 - Zo y Z_
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned giveinotioe of his or her intention to perform the electrical work described below. A
Location(Street&Number) 6 k t- H 4/) /] /2p-et- 0/L vvla t,1)Cor7—
e Owner or Tenant / �7 w
Yl i vt e A C/A. a one No.
Owner's Address
✓ Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box)
Purpose of Building 5 e/2JtLe- C I',g n _✓ der q /ge 'ts sty, athorizatlon No. / I 2 Li 3 `7 '5
Existing Service /OOAmps 7 L t71 Lr(DVells `Overhead dgrd❑ No.of Meters /
New Service D Amps /10 WL'1olts Overhead�Uodgrd❑ Na.of Meters /
cu Number of Feeders and Ampacity
'S Location and Nature of Proposed Electrical Work: A 1)/k.C.t- /V//reZ'U a/e/1/04h,,C .device
., l/✓I/71 0rOO4nVC,9VG/lre4d -•r c4-cc- /.f/!r-e tg't'Cee-1/406e.ye-t2rvC
. Completion of the followinktable may be waived by the Inspector of Wires.
W - No.of Recessed Luminaires No.of Cell:Sasp.(Paddle)Fans No.of 7 oral
Transformers KVA
t 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
IL! No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices
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❑MunlelpannectionEl Other
Co
No.of Dryers Heating Appliances KW Security Systems:.
No.of Devices or Equivalent
No.of Water , No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wring:
No.of Devices or Equivalent
OTHER:
Attach additional detail tfdesired,or ar required by the Inspector of Wires.
Estimated Value of lectecal WorlerV it4C0 (When required by municipal policy.)
Work to Start: !t 24 LZ Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVE GE:Unless waiv by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability i rance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such cov a is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND❑ OTHER 0(Specify:)
I co*,under the Alm,an penalties ofpeytrry,that the information on this oppfkadon is true and complete. b
FIRM NAME: /(/e i L- .S C t'10�4e i- / /J LIC.NO.: 13,2
3' /
Licensee: Signature /yCd ��d/f/4 — LIC.NO.:
(If applicable.enter"exempt"in the license number line.) lint.TeL No.' Ci7 r-T76/8S7
Address: Alt.TeL No.: 11//o
"Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER 1 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. lam the(check one)0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE:$