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Home My WebLink AboutBLDE-18-005757 n Official Use Only ,. . Commonwealth of tE Massachusetts Permit No. BLDE-18-005757 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked p.m I/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 INFORMITION) Date:4/17/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives no ice o us or her in en ion o per 'm •c ccct^rtca work described below./ ,t /� Location(Street&Number) 17 REARDON CIR H-S 1 - 1LIt CAL. --- Owner or Tenant VIRTOM LIMITED PARTNERSHIP Telephone No. Owner's Address 2 ATLANTIC AVE,SOUTH YARMOUTH,MA 02664 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 ❑ Undgrd 13 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: Upgrade lighting 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 0 In- o 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 • Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers (teat Pump Num her Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Paul M Morris Licensee: Paul M Morris - Signature LIC.NO.: 17520 (If applicable,enter"exempt"in the license number line.) Bus.TeL No.: Address:PO BOX 213,1 COUNTRY WAY,SAGAMORE MA 025610213 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) ❑ owner 13 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $80.00 llIi*( � _.,.. nq g, q�� / ` e•wwertmmtl.of Visna acarus Officta1Use Only •� Sin - r } JJapartmant015tniStrand PamitNo. -=: BOARD OF FIRE PREVENTION REGULA ONS r.1aat1/O7] and Checked tr_p Nave monk) APPLICAtION FOR PERMIT TO P: RFORM ELECTRICAL WORK Alt work to be pertained in accordance with the Massa .ik Deistical Code (PLEAS RPRINT'RIh7KOR -S ALL INFORMATION) Date: p Bhi or'Dims of: \, 1 ' s a To the��fi -527 o By this application the undersign .,notice of his or her intend.n to perform the electrical work descdedbelow. Location(Street&Number) I _ , ; r a I V K t+ A-, Owner or Tenant • es 2...... .D ►.. q Owner's Address a a. • • Is this permit to conj®coon with n�sa� p l Purpose of Building building permit? Yes II No 0 (Check Appropriate Box) • Utitity Authorization Na Existing Service _4._ Amps / Volts Overt:.:d 0 Undgrd 0 No.of Meters ew ervice I Amps / Volts Number of Feeders and Ampadtp Over): 'd Undord❑ Na of Meters t Location anti Nature otProposed Electrical wm • r_ . ,;ie� — I I 1 Seritirtint Com,letio o the o11owt • table , • be salved• theI -'actor of Hires. No.of Cer'l.-Snsp.(Paddle)Fans 1ransformers °tal Na of Luminaire Ogtiets Na of Rot Tabs KVA Generators KVA SwimmingPooi ;"rove Ilao mergence • . No.of Receptacle Or lets - d- Ba. Utdtr g Na of Oil Barmen - - • i• " . Na of Gas Bunters ,a o Mani on sn® No.of Ranges I Iaitie Devices Na of Air Gond •ns No.ofAlettingDevices Na of Waste Dlsposer's z ' , , ` „M , 1 Tshls. � • MI Det on/A eerttn Devices No.of Dishwashers i Space/Area Heating I(Wccerpp No.of Dryers I Heating APPLoad 0 Croar yyO7mec?1on 111 Othera o o• Data W ring�icee or E,ntvalmt SiTetil .s Ball: Na of Devices or E.nivalent No.of Motors �. - To� ecommnmcattons rrmg..� OTHER era DevicesorE,uivalent EstimatedValtleofEleCRiCajyyodc Attach addict-nal des!!t!desiredora,requited 0 eJ Work to Start: inspection _ en • bemmmicipalPoticY) nrpeclorofiYlree INSURANCE COVERA E: Unless waived Quested er,no ,nn ,., --with MEC Rule el and upon completion the licensee provides prod ofliabi' by the owner,no permit . thepertnn of electrical work may issue unless licensee provides that such liability including"completed .,a on arils substantia! equivalent CHECKONE INSURANCEahtith erage is in force,andbasexhibited .. ..fofsametothepetmitissniagoiUe The I HECrC0itder&e d BOND 0 OTHER 0 (Sp-(SP - -) FIRM NAME: f`1 inis fP�rrn3 thanks iu form¢do on this application is true and complete.r�rr Q.c..t- _L,V LIC.NO.: lino*- Licensee: iii-L (L Q G signature � (jjapplicabl. enter eamnpr'to heaeaaemaaberlra- - LIC.NO� Address a s r1U G 6 Bus.TeL No b 2 In 96^1 Lit*Per M.G.L e.147,s-57'61,securityweakrecur:aDepartnent ofPnb c S�y"S"Litsurse: Alt.Lit.Tta No. NGD a 6 3 OWNER'S INSURANCE WAIVER: I am aware that the Licensee do: not have the liability insurance coverage normally Sirequired by law. By my signature below.'I hereby waive this -. i a I am the(check one)0 owner 0 owner's agent Owner/Age I Telephone Na I PERMIT FEE:S f•O 1,0 I gnature7n,n.eA9-c4•-ri L QC-e zcszk. '