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HomeMy WebLinkAboutBLDE-19-003212 Commonwealth of Official Use Only kik Massachusetts Permit No. BLDE-19-003212 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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:11/26/2018 City or Town of: YARMOUTH To the Jnspejtor of Wires: By this application the undersigned gives notice of his or her intention to pc m the c.Fctrical work describe fl/fw. . ,�(� Location(Street&Number) 7 MCGEE ST A--/�/ Cy 141C:fV Owner or Tenant ARBOGAST JOHN D JR Telephone No. tot (-57 5.7 Owner's Address JOHNSON WILLIAM F,5 NANA'S WAY,WEST YARMOUTH,MA 02673 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 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 furnace. 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- 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 No.of Gas Burners 1 No.of Detection and Initiating 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 ❑ 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 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: $50.00 R 1 ebe, 6s • "' l�ommoruasa of/r/asaacaff! Ofiici Use On • _� c-/ v • `/�� .ryry,,aparbnenl o f g e Services Permit No. • -1 I Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS "Rev. 1/p (leave blank) r APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ),527/592.00 (PLEASE PRINT IN INK OR TYPE ALLINFORMATIO?v7 Date: N ' o / City or Town of: YARMOUTH To the Inspector of Wires: . By this application the undersigned gives notice of his or her intention to perform thee,ctrical work described below. • Location(Street&Number)4 J - - S _ ,NF • �, . —pho.• t - r. OwnerorTenant iV ��ie2 Te[e , Owner's Address 0-4•12._ No.- � /....07.57 Is this permit in conjunctio with a uriding permit? YesNo t E (Check Appropriate Box) Purpose of Building �� Utility Authorization No. Existing Service/QA Am s p/aQ /14.40Volts Overhead gi d Undgr eco ettice " El No.of Meters `�q - Amps / Volts Overhead❑ Undgrd EI No.of Meters m, " m Nq .: of Feeders and Ampacity . a. a K •. Loc till an• Na re of Proposed Electrical Work: r .4. l > 1ypN i' I p hw--j --`a..._. ♦ ,444 AnJc� ci-ALui rc, S-t.4-i r r ill e'1 Completion of thefotlowing table may be waived by the Inspector of Wires. ( oNO2Nd�oecessed Luminaires No.of CeiL Stop.(Paddle)Fans No.of Total(,) M Transformers KVA ill NP o iLuminaire Outlets No.of Hot Tubs Generators • KVA tx "bQ aj',Luminaires Swimming pool Above ❑ In- No,of tmergency Lighting - erncL grad. ❑ Batt Units No.of Receptacle Outlets . No.of O0 Burners FIRE ALARMS 'No.of Zones Y No.of Switches No.of Gas Burners No.of Detection and - O Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained © Totals:I I f Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Leal❑ Municipal — Connection ❑ other rU No.of Dryers Heating Appliances KW Security Systems:` No.v. of Water No.of 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.of Devices or Equivalent OTHER: U �-► Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of E�ctri al Work J i (When required by municipal policy.) kik Work W StartJ//:�/� ons to be requested INSURANCE C VE /� � in accordance with MEC Rule 10,and upon completion. 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 undersigned certifies that such cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) t FIRM NAME:the pains and pen. ' s of perjury,that the' form. 'on on this application is true and complete. Lead - •e-- 1 _ - : to —1- c-- LIC.NO.:a) Licensee: C j �C��4/ Signature '/-..rt ��, �� LIC.NO.-���'laXL[L Li applicable, enter"exempt"in the license eor,iber line.) Bus.Tel.No: . Address: 37 tf i Ga rrl�! etd-e DPt tie De4.•W lI • Nl j `Per M.G.L.c. 147,S.57-61,seburtt}lwork requires Department of Public Safet/'S"License: Alt.LieTe`No. vse — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally ic required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent 1 Signature Telephone No. I PERMIT FEE: S I