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Home My WebLink AboutBLDE-19-0001539 CO aCommonwealth of 0OffcialUseOnly Massachusetts Permit No. BLDE-19-001539 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:9/13/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described be w, Location(Street&Number) 48 SUFFOLK AVE 3 (4/4-4 ) 4t 'Ca Owner or Tenant A J LUKE TR Telephone No. Owner's Address THE KARL E LUKE RLTY TRUST,48 SUFFOLK AVE,WEST YARMOUTH,MA 02673 Is this permit in conjunction with a building permit? Yes ❑ 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: Replacement boiler. 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 ❑ !n- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners 1 No.of Detection and initiative 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 ICW 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 ❑ BOND 0 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,a.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 q e It Signature � (� Telephone No. PERMIT FEE:$50.00 ct e. `l e 7/i I tI • ..g.-- _ Common<ocalt/s of 7t fasaae elle •. Official Use OAy ry�epartnrad �7 tra �i • Pemut Nc��"( — J 3 ' 3crriectl = BOARD OF FIRE PREVENTION REGULATIONS 'Rev. 1/07]Occupancy and Fee lank) Rev. 1/D7] ((cave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME 527 r I ZOO ° ' (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: e 02. if City or Town of: YARMOUTH To the fn - tor of"ires: '^ . By this application the undersigned gives notice of his or ' tention to perfo .. the electical work described below. D1 pop- Location (Street&Number) / • ` áe y, r _ tVt"1, ( Owner'orTenant c(qfr/ QV G y �e Telephone No. .�� '\p6.1i,' Owner's Address Sea_ Is this permit in conjunction with a tiding permit? Yes ❑ r:79./1 (Check Appropriate Boz) Purpose of Building /2 Utility Authorization No. ExistingServicre/O o Amps/cao/IaYA' Volts Overhead Undg, ❑ No,of Meters) New Service Amps / Volts Overhead❑ Undgrd ❑ No,of Meters Number of Feeders and Ampacity U/p .e ,pJ /�,a Location andjFa rrp of Proposed Electrical Work: L/� /T Q ~ Completion of the forlowinr,table may be waived by the Inspector of Trans, Wom fr I ik No.of Recessed Luminaires INo,of Cen..-Sasp.(Paddle)Fans ' N0'of Total N� Transformers (CVA 1. VA a �' No. of Luminaire Outlets INo.of Hot Tabs IGeaerators • [(VA W :--1 w No. of Luminaires 'Swimming Pool '°`hove in- h, 0No.of mergency lighting O orntL ?rued. 'No. Units • ei tL 0 No. of Receptacle Outlets . No.of Oil Burners !FIRE ALARMS INo,of Zones W Ili l(J to No,of Switches No.of Detection and — No.of Gas Burners Cd a' No.of Ranges Total Initiating Devices 'No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Pleat Primp I Number Tons KW INC.of Self-Contained Detection/Alerting Devices No.of Dishwashers SpaTotals: Space/Area Heating ICWMnniclPl L°ca10 Connection 0 Other \ No.of Dryers (Heating Appliances KW SecuriV Systems:' % No.of Water No.bf Devices or Equivalent Heaters KW No.of No.of Data Wiring Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring.No. ` OTHER: Na of Devices or Equivalent �_ Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of El tri Work ??37e— (When required by municipal policy.) Work to Start 9p�r fictions to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO GE: Unless waived by the owner,no permit for the performance oftlecttical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent The ^i undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. j CHECK ONE: INSURANCEYQ BOND 0 OTHER 0 (Specify.) / I terrify, ander the pains and pe s of perjury,that th info on on this application is true and complete. FIRM NAME: (act f iC LIC NO.: /.�"-f0 `� Licensee:�eG� ern,�y/ Signature ` LIC NO U (if applicable,enter' pt"in�1,e license m m er li /� �� Address, Z7 (g4/1/79/ / / Bus,TeL No: r " �n✓� / Alt.TeL No c_�d ,"J *Per M.G.L.c.147,s.57-61,se work requires Department of Public S ety"S^License: Lie.No. Q OWNER'S INSURANCE WAVER: I am aware that the Licensee does nor have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agen Owner/Agent I PERMIT FEE: $ ! A Signature L! Telephone No.