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Home My WebLink AboutBLDE-19-001959 114 commonwealth of Official Use Only f Massachusetts Permit No. BLDE-19-001959 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked f Rev.l/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:10/2/2018 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) 597 FOREST RD Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address CENTRAL DUMP, 1146 ROUTE 28,SOUTH YARMOUTH,MA 02664-4463 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (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 generator. (40 KW) 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 1 KVA 40 No.of Luminaires Swimming Pool Above ❑ I - ❑ 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 Initiatinc 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 KW Security Systems:" No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Sins 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Brooks R Wilson Licensee: Brooks R Wilson Signature LIC.NO.: 21572 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:416 WAREHAM RD,APT 3,MARION MA 027381574 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:$0.00 £1(A60 Com- Icor 2unvivi 6< t-o(?/'e - QGGi i 6741 e W np gt�� rir} l.Onvmaam.aLth o`/llaalacl waft! Official Use Only (SIC.—l�lS'1 4.T...-.WILT.., ryry,, c7 ��aa Permit No. — ivThepariment o f Jin Simko! j Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07] (leave blank) ci APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Lull H All work to be performed in accordance with the Massachusetts Electrical Code ), 7 CMR 12,00 :+ o(' EASE PRINT IN INK OR TWA*ALL INFORMATION) Date: q/ O 1/g 0 City or Town of: Y4 to oath To the Inspector of Wires: ill zthis application the undersigned gives otic f his or her intennttioontoperform the electrical work described below. V -j .radon(Street&Number) >� USS-f Wm Ii t er or Tenant �p�tWrl O c 5Iez m —1/&q 0lilan nS .eccr S4i b Telephone No.5C&398-2?3/ f2e rwner'sAddress ll'0(a /Zetr-le ggR 501Yi-v yctgI)1O1)+3/4 /gym O?Ot'etf this permit In conjunction�/ with a building permit? Yes ❑ No D (Check Appropriate Box) Purpose of Building/ (gent e42C &Q. Utility Authorization No. Existing Service 2110 Amps )2-0 1203-Volts Overhead®, Undgrd 0 No.of Meters if New Serviec _ Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Cyd ve ewe{ - Heft London and Nature of Proposed Electrical Work: (4p>ace 4.15 4tttl 9e{'t6.44d 2 Q►'ie-A -kali S ccel- SW t 44-11 . Completion of the following table m be waived by the!ns!inspector of Wires. otal No.of Recessed Luminaires No.of CeiL-Soap.(Paddle)Fans No.osfo T Transformers KVA u No.of Luminaire Outlets No.of Hot Tubs Generators KVA yi No.of Luminaires Swimming Pool Above ❑ In- ❑ No.oeryUnits cy Lighting g grad. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.on Detection and Initiating Devices No.of Ranges No.of Air Cond. Total ons g Tons No.of Alerting Devices No.of Waste Dia Deers Heat Pump Number `Tons KW No.of Self-Contained P Totals: ' [-' Detection/Alertin Ikvices No.of Dishwashers ' Space/Area heating KW Local❑ Monneunicictiopa�n El Other No.of Dryers Heating Appliances KW Security AN oCf Devicessor Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications oWiring: OTHER: 'b0 W Attach additional detail if desired,or at required by the Inspector of Wires. Estimated Value o EIf ctriiccal Work: -5 (When required by municipal policy.) Work to Start 9/5-f/p 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 0 BOND 0 OTHER ❑ (Specify:) I certift,under the pains,a,nd penalties of pe ury,that the information on this application Zr true and complete. FIRM NAME:Bgo cs SAY I Son e ec . • • A . LIC.NO.: ?Inc?* 1L. Licensee:.!. S 1 Sei Signator JtI�l�7"�fa. LIC.NO.:37(p 47-- ((fapplkable,ggryrytter "exempt-"/It-n the licens uprberlina, Bus.TeLNo.z340$:W"-W10 Address: itis CMQ wt GC. �7/tlaQ/rti1 A 02'73 S' Alt.Tel.No.: *Per M.O.L.c. 147.s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVERt 7 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. I am the(check one)0 owner ❑owner's agent. Owner/Agent I PERMIT FEE: $ Signature Telephone No.