The URL can be used to link to this page

Home My WebLink AboutE-19-785 q\e/7 'f or Commonwealth of Official Use Only kr® Massachusetts Permit No. BLDE-19-000785 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.I/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:8/9/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of has or her m(ention to perform the electrical work described below. Location(Street&Number) 329 ROUTE 6A Owner or Tenant FIRST CONGREG CHURCH OF YARMTH Telephone No. Owner's Address ROUTE 6A,YARMOUTH PORT,MA 02675 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 v_ 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: Remove meter socket. 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. gnd. 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 Data Wiring: Heaters Stens 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 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:) /certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Mark J Potter Licensee: Mark J Potter Signature LIC.NO.: 18218 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:280 SOUTH ST,D/B/A POTTER ELECTRIC,DOUGLAS MA 015162717 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 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:$80.00 Qo[fe(19 re sL efu(i$ �r if g4 Commonwaath o`TAmachutia 101'�ffii))cii(a�ll,,Use Only/ n==�- C-we e� e7 n Ct-t —(0785 3. 'r 3a/artn.nt o/J.-caw Permit No. -tows V • ; I1- Occupancy and Fee Checked °� , BOARD OF FIRE PREVENTION REGULATIONS .1/07] (leaveblank) nV� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC).521 CMR 12.00 I (PLEASE PRINT IN INK OR TYPE ALLgFORMATTON) Date: $-(-IB City or Town of: Yin o� pQre r t To the Inspector of Wires: "' By this application the undersigned gives notice df Itis or her intention to perform the electrical work described below. Location(Street&Number) a9 nP,✓ Ck rtes .10 -]g0 0 Owner or Tenant ',ST Carle rc..e 4;o✓n1 CL,rr+ a Ymsnov1L Telephone No. 5D8-36).-6977 1/4"'' Owner's Address 33.1 f1A v Sit,€ -k- Is this permit In conjunction with a building permit? Yes 0 No ® (Check Appropriate Box) Purpose of Building pm Utility Authorization No. 1,lfd Existing Service PA Amps / Volts Overhead❑ Undgrd 0 No.of Meters 04 New Service PA Amps / Volts Overhead 0 Undgrd 0 No.of Meter _ Number of Feeders and Ampacity P �9 NFl Location and Nttan of Proposed Electrical Work: '�,...a,,,� tZoo A \ pr T- (10\,L no.L/, 04141 .• A.✓m re 9L .- W AAL G-r - 9-r+a- rks.L Completion of thefidlowing.table m be waived by the Inspector of Wires. W No.of Recessed Luminaires No.of CeIL-S (Paddle)Fans No.of Total mP' Transformers KVA ei No.of Luminaire Outlets No.of Hot Tubs Generators KVA C. e � No.of Luminaires SwimmingPool Above ❑ In- i.-1 tvo.of emergency Lighting grnd grnd Battery Units `) No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones t No.of Detection and No.of Switches No.of Gas Burners Initiating Devices 0a. t LI i z N,,.of Ranges No.of Air Cored. Total No.of Alerting Devices N .of WasteDisposers 'lint Pump Number Tons 11W No.of Self Contained w z- ITotals: __� Detection/AlertI g Devices r - c�a r;Na of Dishwasher Space/Area fteatlng KW Local❑ Municipal 0 Other e. Comneetlon a O N of Dryer Heating Appliances Security of Systems:* w No. Devices or Equivalent up ` No of Water No.of No.of Data Wiring: —) Heater KW Signs Ballasts No.of Devices or Equivalent U 1Telecommunications Wiring: No Aydremassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired oras required by the Inspector of Wires. Estimated Value of Electrical Work: a CDO.' (When required by municipal policy.) Work to Start: Yr-/3—/8 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 21 BOND 0 OTHER 0 (Specify: I certify,under the pains and penalties ofperjgry,that the informs n n this application Is true and complete. FIRM NAME: S ASSoc 1A S Tat- LIC.NO.: I$rZt$ Licensee: 11pzit- ►'o71ef Signature LIC.NO.: ►$d 18 (If applicable.enter"esem�Jtp(in the license hie.) 1 Bus.TeL No:no8'-'100-6088 Address: 420 1Ja:ri.boio Raaf C ul .rineihoc owa MA 0s757- Alt.TeL No.: °Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety'S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. 1 am the(check one)0 owner 0 owner's agent Owner/Agent Signature MA Telephone No. NA ( PERMIT FEE:$ gt7 '—