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HomeMy WebLinkAboutBLDE-18-005350 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-18-005350 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:3/28/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice at his or her intention to perform the electrical work described below. Location(Street&Number) 41 NORMA AVE Owner or Tenant JORDAN LEONARD F JR TR Telephone No. Owner's Address LEONARD F JORDAN 2010 IRR TRUST,41 NORMA AVE,SOUTH YARMOUTH,MA 02684 Is this permit In conjunction with a building permit? Yes 0 No 0 (Check A 1s rate Bon) Purpose of Building Utility Authorization No. �[ Existing Service Amps Volts Overhead 0 Undgrd 0 'o. • W New Service Amps Volts Overhead 0 Undgrd ❑ f Number and and of Ampacity pposed /^l '` IC] Location and Nature of Proposed Electrical Work: Wiring for 3 seasons room. 11 �7] Completion of the following table may be w d - r •-clan of Wires. No.of Recessed Luminaires No.of Ceil.Susp.(Paddle)Fans 1 No.of 0 I Transformers � No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grad. Battery Units No.of Receptacle Outlets 6 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners No.of Detection and lmtiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste DisposersTon Heat Pump Number 1 Tons 1 KW No.of Self-Contained Totals: [ Detection/.Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other. Connection No.of Dryers Heating Appliances Sccuriry Systems:* KW No,of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heater tins Ballasts No.of Device or Equivalent No,Hydromassage Bathtubs .of Motors Total HP Telecommunications Wiring: No.of Device,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,sander the pains and penalties of perjury.that the information on this application is true and complete. FIRM NAME: Mark A Wermers Licensee: Mark A Wermers Signature LIC.NO.: 10563 (If applicable,enter exempt"in the license member line.) Bus.Tel.No.: Address:29 LOCUST ST,S YARMOUTH MA 026645617 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:lain aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) 0 owner ❑owners agent. Owner/Agent Signature Telephone Na. I PERMIT FEE:$75.00 Cube /2.=#(/0 _ .4 - - egns..M.or.cage g of ma•L.442-c is - Official Use vµ'J . i -_-tf FF cc''�, / q Permit No. =re_' 2cparti,u,,.f oJ'.j,•s J wr:-ed Ot.,.upancy and Fee Checked --- BOARD OF FIRE PREVENTION REGULATIONS [Ara. lN71 (lezvebkank APPLICATION FQR,PERMIT TO PERFORM ELECTRICAL WORK uJ All wort to be perfnrined in atcvrdaoce with the Massa;hose Electrical Code(MEC),527 OAR k ZD+1 (t'LEA.SE PRINT INDXOR TYPE ALL INFOR.MA77Ol'o Date:__ -Z7-1 F-41 B City or Town of: YMQ 'g To the Inspector of Wires: m 1 Y application the pndersimed s notice of his or her intention to perform the electrical wort:described below. N . Location (Street&Number) ! I � �{ '/f,/ ,r — .0 #- Owner'or Tenant // �i rT St W eat *� OrJ�1/?D OPIAf.J Telephone No. �T {? = Owner's Address < f, N� � �� 9, Q W Is thus permit in conjunction wit a bundin�permit? Yes X. Na ❑ (Check Appropriate t Purpose of BtuZdmo 1'La5/prr.✓ Fp Priste Box) �� a 1 f Utility Aotorimtion No. E Service /oo Amps /Za /1-40 Volts Overhead rg lrindyrd New Service _Amps / VoltsOverhead E CJna • lt p-d❑ No.of Meters Nuin5er of Feeders and Ampacity Location and Nair_of Proposed Ele rival Work. W I QC 3 5 e4 Km - - _ Coral or,of the foIIawa,a table may be waived by the Inmecior of F}ems. No.of Recessed Lur ueir•.,s No. of Ce L-St:sp.(Paddle)Fans l'20.of Total ITrzasformers KVA No.of LWnia.af-•.Otrtie !No.of l?ot Tubs 'Generators • KVA • • No.of Luminaires Swimming Pool !abov_ arnd 0 Ie ❑ ia- ND.ofenv J t m uftergsrcy i.raht�r erttdBai No.of Receptacle Oude+s b !Na of Ott Burners FIRE ALARMS il�To.of Loam No.of Switches I [No.of Gas Bu e rns No.of Detection 'an-d • IntaaftnE Devices No.of Rate INa of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Conlaiaed Totals: Detection/ilertlne.Devices No.of Dishwashers i Space/Area Beating KW' IT-kcal❑MCoaneetitr�i�pai on 0 Omits No.of Dryers IHeatzn;Appiiancas KW Sm-nrtty Syystets "—� No. of Water No.of Devices or Equivalent No. Heaters KW of No.of Data Wiring: --'--, Sias Ballasts Na of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP elecoatmntucatioas trtnb No.of Devices or Equivalent O1rihR , Attach additional detail Y"derired ores required by the inspector of Wires. EstimatedValue of Electrical Woriv Z C 2 (' 'hen required by muni, al policy.) to Start p �•) Work 3-Z7-1 le Inspection to be requested in accordance with MEC Rule ID,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue tmless the licensee provides proof of-liability insurance mclt,rtirg"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 ofice. CHECK ONE: INSURANCE (X1 BOND ❑ OTHER 0 (Specify,) I certify,sunder the pains artd panalEes of pQ.j ,,that the information on this apprrccdon is true ezd COeeP1ete. FIRM NAME: - - - C ...4_J LIC.NO.: O63 Licensee: ' ty ig.K /AJC-�y - jp Signature Les._ LIC NO.: (If applicable,enter"ezempr"in the license number line) Bus.Tel.No.; G 6!ZD 9 L . Address: 2. oc4.,S1 c S wfiZst drP( Al�I¢- Alt Tel.No.: J `Per M.G.L. c, 147,s.57-61,security work requires Department of Public Safety"S"Unease: Lie.No. OWNER'S INSURANCE WAIVER I am aware that the Licensee dons not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement I am the(ohmic one)0 owner 0 owner's agent Owner/Arent 1 Signature Telephone No. t PERMIT FEE: $ ,y i•f �� CO rn.rr-o. �1i oil r ray 2� Om C1El Use Only 2�i.C.C/:lt: :�. • __ _ __ ' ,� • _�'-- • =. ��--i :: --71- 1,V � � - ..t of 7 � Permit No. Aw " ,___Z5:d. Occ�Tpancy and Fee Checked >, ,,4* BOARD OF Fl RE PREVENTION REG�L',i!�DNS I�ev. 1107� (leave blank) APPLICATION .FOR= PERM .T TO PERFORM ELECTRICAL v� O R i i All work to be performed 'a BcCor'id ncG " r lie: M2s;aehuse:u Electrical Code (MEC), 527 ClvIR. 12_DO (PrEASEPPLINT IN INK OR TIT. 'ALL INFOTt_16._y'1'?1\9 Date: 3 17 1 r City DI Town o f: YMOUTH _ To the Inspector ofWires: ' ; ��, 1 . By this application the pnder.si�ned ves notice cf his or her ir: .ntion to perform the electrical work described below. 4v. -'. Locaon (Street c� Number) : .. �"�r u°:.•- �W. Owner or Tenant � _ ...L,z,rz.4:16e .,•,, _ Arci! .jie; ?23 t. .:'' '3"9 .4) Telephone No, , .a, :,� 11 O wn e- Address 1 '�')✓4 , 't� , S. (M r`.: c):: r ,� C '° ) C ✓ 1 i;i IS :his Permit in conjunction with a funding- Permit? Yes j No (Check Appropriste Box) . 1.,...., ', Pt—pose of Building (' j 51 -✓751 Utlity Authorization No. - . . . .>--.-- Existing Service /0© A n-ps j zo I e-cie Volts Overhead ig. Undgr-d No. of Meters / New Service Amps / _ Volts Overhead _, Undgrd No. of Meters ' Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work- j,,t,Iiz� 4c �(� Cotnpl_tian of the foiawaza-table may be w&ved by the Inspector of Ft'rres No. of Recessed Lsrninaii es iNo. of CeL.Susp. (Paddle) Fans Tr' s G TVA I Transformers IL'VA No. of j rrmiTra re Outlet 1No. :of Hot Tubs Generators KVs I�a. of Luminaires4b ove ❑ - o. of Lmerg`ncy g ung �Swi'rr -riTng Pool arrcd. r Id. ❑ Batten units Receptacle Ouse k. iNn. of OilBurners Fn>L A.4Rh�IS No. of?ones N . of No. of Switches r No. of Gas Burners _ • On. of De`�ectFen _nd • Luitiaans Devices No_ of Ranges _ 1INo.. of Air Cond. To Total �No. of Ale�tiag Devices No. of Waste Disposers ;Heat Pump Number I'Tons I KW IN a. of Self-Coritairred Totals: I DetectionlA_Iertintz Devices I.Na. of Dishwashers 1 Space/Area Heating KW• Local ❑ Mucci ai ❑ � Connection Na. of Dryers alHeating Appliances , Security Systems:* No. of Water No. of Devices or Equivalent • Heaters 'W INo• of No. DI Data 'Wiring: Ballasts No. of Devices or E trivalent 5i4ns No. Hydromassage Bathtubs No. of Motors Total HP Telecomnrutations Wiring: ( Na. of Devices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estin-rated Value of Electrical Worly Z c (When required by municipal policy.) Work to Start: 3 — Z7 l Inspections to be requested in accordance with lvtC Rule 10, and upon completion. _NSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance incluriing "completed operation" coverage or its substantial equivalent, undersi gn:d certifies that such coverage is in force, and has exhibited proof of same to the permit issuingornc The CHECK CNE: INSURANCE 17 BOND ❑ OTHER 0 (Specify-.) f carnfy, under the pains and penalties of perjury, that the information on this application is tr z.e and complete. FIRM NAME: P 1 Yl 7 - r—LL= G LIC. NO.: .S t� . s Licensee: r/Z jC ''-Zf -)4-:-?i..5 Signature a 1'17, LIC. N 0.: (If applicable, enter "esernpt" in the licerrs 7i r- ; • line.) Address: Bus. TeL No.:SS'v5r�G.2.� �i i-cc..=i'?S7r 7illarhoi"%/7 /J� 1 ' Per NLG.L. c. 147, s. 57-6] , sCntof ety �, Alt. TeL No.: OWNER'S INSURANCE WAN1,.-,_: am^a„aims �es that the Licensee noblic sh e the liabilityS" License: Lin.insurance c • � required by law. By my signature below, I herebywaive this r coverage normally C�wrtei 'Agent equirement I am the (check one ❑ owner ❑ owner's a ent LI1 Sc?natZ..re Telephone No. PERMIT FEE: $