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Home My WebLink AboutE-19-1135 Commonwealth of Official Use Only a��a�. � Massachusetts Permit No. BLDE-19-001135 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:8/24/2018 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) 191 MID-TECH DR Owner or Tenant TIERNEY JAMES Telephone No. Owner's Address 191 MID TECH DR,WEST YARMOUTH,MA 02673 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement heater and add service switch. 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 ❑ ln- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 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 0 Municipal ❑ Other: Connection No.of Dryers Heating Appliances 1 KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Gary L Gordon Licensee: Gary L Gordon Signature LIC.NO.: 15290 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:37 BILLINGSGATE DR,DENNIS MA 026382234 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 ant the(check one) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$80.00 • Commomrueaflh ofc/7t/c 44.cLetti Official Use Onlynl ---5-n�lg JJGPa+G,�enE o{,yirG.� 'Permit No._C 1 —I� /5 _ Gn,icc i Occupancy and Fee Checked ' BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/073 . (leave blank APPLICATION FORIPERMIT TO PERFORM ELECTRICAL WORK et-1YAll work to be performed in accordance with the Massachusetts Electrical Code i.s ,527 r r 12.00 (PLEASE PRINT IN INK 01? TYPE ALL INFORMATION) Date: 1" • 3City or Town of: YARMOUTH To the Inspe for of Fires: By this application the pndersiped gives notice of his or her intention to perform the electrical work described below. • Location(Street&Number) /9/ 7c.; /e �,-1.../11,-e u ,. _ o ltwner'orTenant (SaeINq , - j�� y Telephone No._7 "Q�es �nil Z m g (LI w swner'sAddress es l; s this permit in conjunction with a building permit? Yes E NoCheck A IMMI °� w 'urpose of Ewld ng SN31 I ( Appropriate Bat) LLI cit o did f S Utility Authorization No. acting Service 0 = z * Amps/pi) /09K)Volts Overhead IIadgrd❑ No.of Meters Lu e o l ew Service Amps / Volts Overhead❑ Undgrd 0 NO.ofMeter _ k� j 1 umber of Feeders and Ampacity l/tjl� peq/zce v17e �e �J/__ GI m ocation and Nature of Proposed Electrical Wort: /'/ ��,TP�' • �,54, SG/fv7ce SW/ . . . .. . Completion of the following table may be waived by the Inspector of Wirer. No.of Recessed Luminaires INo.of CethSusp,(Paddle)Fans No,Transformers ICyA No. of Luminaire OurIe+s INo.of Hot Tubs Generators • (CVA No. of Luminaires ISwimavng Pool Above ❑ In- INo,oimeigeacy J.aehung aritd. arnd. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALAELM14S No.of Zones No.of Switches No.of Gas Burners No.of Detection and faith/dna Devices No.of Ranges 'No. of Air Cond. 'loth No,of Alerting Devices • Tons No.of Waste Disposers Heat PumpTNumber I'Tons 1KW No.of Self-Contained Totals:I Detection/Alerting Devices ® No. of Dishwashers Space/Area Heating KW' Municipal Local 0 Connection 0 Other No.of Dryers (Heating Appliances Security Systems;` \ No,of Water No.of Devices or Equivalent C MW No.of No.of Heaters Data Wiring: Signs Ballasts \ No.of Devices or Equivalent 1_(.) No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: \ '375---- Attach additional detail f desired or as required by the Inspector of Wires, tVCJ Estimated Value of El :McWord 37t (When required by,municipal policy.) Work to Start g�t�/ �r Inspections to be requested in accordance with MM Rule 10,and upon completion. INSURANCE C(WE GE: 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,, BOND 0 OTHER 0 (Specify:) I certify,ruder the pains andpenalties of perjray,that the information on this application is true and complete. FIRM NAME; 5'-"5, t/4--p:.. ��,..G \I) Licensee:a: / LIC,Ne d (� Signature LIC.NO. � _-� (If applicable,enter" pr"in t/hj license number line Bus.Tel.No: `/ Address: 1 s t D�1-ty Alt.TeL No. J "Per M.O.L.c. 147,s.57-5i,se w requires Department of Public Safety"S"License: Lic.No. '�_JI_LJ�mG'777r - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n�- S required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agent t Owner/Agent IASignature. ntTelephone No. PERMIT FEE: S