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HomeMy WebLinkAboutE-19-2859 j � Commonwealth of Official Use Only 'kr Massachusetts Permit No. BLDE-19-002859 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.1/07] 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:11/8/2018 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 below. Location(Street&Number) 714 ROUTE 6A Owner or Tenant OLOUGHLIN JOSEPH V TRS Telephone No. Owner's Address OLOUGHLIN ALMA C TRS,2 HAROLD ST, HARWICHPORT, MA 02646-1517 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: Air handler&condenser. (UNIT A"OVERLOOK") 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- 1:1No.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 Initiating Devices No.of Ranges No.of Air Cond. 1 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 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:' No.of Devices or Equivalent No.of Water , 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:) 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 am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$80.00 � , ,� � t141r� -- +"-1 . C/� A�trr y� t1 ommonweaUt of/r/aaeac�iueatte C,e�al U' Only a 0. �= cr�Al . 7 Services Permit No. �l I Nix a u .Urparimenf of Jin Jirvicre 1�.to„ Occupancy and Fee Checked ® mit-?' , BOARD OF FIRE PREVENTION REGULATIONS Rev, 1ro7 �+ j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(I< 527 MR 12.00 PLEASE PRINT IN INK OR TYPE ALLINP RAIATON Date: J/ $ �/ ( City or Town of: a`iro �a7 ) To the Inspector of Wires: By this application the undersignvs notice of is or her intention to perform the electrical work describedgbelow. Location(Street&Number) 7 y,4 64 O f J /— st Pig" , Owner or Tenant ©t/ea. „ta \ Telephone No. Owner's Address VI Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) , Purpose of Building Utility Authorization No. Existing Service_ Amps / Volts Overhead❑ Undgrd p No.of Meters _ New Service _ Amps I Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity nA Location and Nature of Proposed Electrical Work: 12 4IWOC 0_o/if(J 1 r- Completion of the following table may be waived by the Insyrector of Wires. No.of- Totalj1 I -"••••1‘i }tb, f Recessed Luminaires No.of Ceil.-Sasp.(Paddle)Fans Transformers KVA csie� i go. (Luminaire Outlets No.of Hot Tubs Generators KVA ' i � Above In- No.of Emergency Lighting Lu do t Luminaires Swimming Pool gad, grnd. ' Battery Units QeleL t?10 of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones al { of Switches No.of Gas Burners No.of Detection and-- Initiating nd- c Initiating Devices f Total o of Ranges No.of Air Coad. Tons No.of Alerting Devices No.otWasteDis Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: "' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Munnnectioicipaln 0 mer Co )4... No.of Dryers Heating Appliances Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent Heaters KW Ballasts Data Wiring: Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP 1 elNo of Devices or Wiring: OTHER: a/ Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value oft cal t rk: CCP [J (When required by municipal policy.) Work to Start g Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE VE 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 Ctundersigned certifies that such coverage is in force,and has exhibited proof of same to the permit Suing office. CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penaides of perjury,that the information on this application is true and complete. FIRM NAME: $c.-�i e�yL LIC.NO.4a )96 Licenseey flu-s------ Signature' _ / s LIC.NO.:4 jeca, d (If applicable,enter"e t' m he license mnnb line)F I Bus.Tel.No: Address: ,.?..2 Csi (21 .! Alt.Tel.No. i���fU(Od7y *Per M.G.L.c. 147,s.57-61, curity work requires Department of Public Safety"5"License: Lic.No. OWNER'S INSURANCE VAIVER• I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agegt. Owner/AgentPER1IHT FEE:$ C v SignatureTelephone No.