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Home My WebLink AboutBLDE-19-002860 Commonwealth of Official Use Only 0E Massachusetts Permit No. BIDE-19-002860 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 ININK 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) 46 LAKE RD Owner or Tenant BOGGS SIMONNE Telephone No. Owner's Address 46 LAKE ROAD,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: Install air handler. 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 1 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- CINo.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 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 KW No.of No.of Data Wiring: Heaters Signs 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) El owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 tJ '-_ yy�� • • Commonweal o/rrladdachadelts IO�f'tc'a se OnlyJ�Q/� p Permit No. l "� �0 F fl r Thepartaunl of Sin Stearn• i to Occupancy and Fee Checked p BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME 52 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALLINFORMdTIO Date: // .$-/r- City or Town of: kf.' tf`N•tei/ To the Ins ect of Wires: By this application the undersigned gives ce o 6f yc or her intention to perform the electrical work described below. Location(Street&Number) y#/' C/��0 ee S�� Owner or Tenant Sj,tzebre. 66 Dear / Telephone No. !/a'O�/7/7 ) a Owner's Address Is this permit in conjuncHog with rylpiding permit? Yes ❑ No (Check Appropriate Bax) MPurpose of Building Utility Authorization No. J q I Existing Sent,/ 414 Amps/01-6" pea Volts Overbeae Undgrd❑ No.of Meters New Service Amps I Volts Overhead 0 Undgrd❑ No.of Meters _ Cl a ber of Feeders and Ampacity _I/USA// 't �,�cC �C•entk/ �fNu.4-.a� e Will t' I ation and Nature of Proposed Electrical Work: t. 12 (A)I il-e_ ot)�.I AliA— ,N'S.., r•1 QILI Completion of liar following table maybe waived by the Inspector of Wires. ��n a No.of Total r p jp .of Recessed Luminaires No.of Ceti.-Sasp.(Paddle)Fans Transformers KVA V o I° o.of Luminaire Outlets No.of Hot Tubs Generators A f Jf! Z'� o Above In- No.of Emergency Lighting rw 1 o.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units `i • No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones L No.of Switches No.of Gas Burners No.of Detection and Initiating Devices III No.of Ranges No.of Mr Cond. Tonal No.of Alerting Devices No.of Waste Dis posers Heat Pump Number, Tons•___IKW No.of Self-Contained P Totals: �] -' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal El "her Na.of Dryers Heating Appliances KW SAtems:* N oCf Devices or Equivalent 4%\\*CX No.of Water ICW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.H dramassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: y gNo.of Devices or Equivalent OTHER: ` Attach additional detail if desired or as required by the Inspector of Wires. � Estimated Value of c cal Work: fJ (When required by municipal policy.) Work to Start: L' Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCI,ERAGE: nless 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 Et (Specify:) r I certify,under the pains and enalties of perjury,that the information on this application is true and complete. FIRM NAME: ryrf/L ) f- 'fjC4 i LIC.NO.:/TA /n-re Licensee: y, r i Signature � Wile LW.NO. ?c,J/ (If applicable,enter•bre•pp11,,nt r e icense number t! e) P Bus.TeL No.' Address: 37 (K� P qe,.*4 � /� / Alt.Tel.No.: *Per M.C.L c. 147,s.57-61,s w requires Department of Public Safety"License: Lie.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. I am the(check one)0 owner ❑owner's agent Owner/Agent Signature Telephone No. PERMIT FEE:$