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Home My WebLink AboutE-19-3260 Commonwealth of Official Use Only E. Massachusetts Permit No. BLDE-19-003260 �' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/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:11/28/2018 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) 1329 ROUTE 28 Owner or Tenant SURPRENANT WILLIAM J TR Telephone No. Owner's Address BISQUE BOY RLN TRUST, 1329 ROUTE 28,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 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: Repairs as noted two years ago during inspection. 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- ❑ 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 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 Scans 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 ❑ OTHER 0 (Specify:) I cernfy,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 Ufapplicable,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"5"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 C 9 o Jcf(s ✓r� „ � Commonruea of/t/cad¢c eft• _, (/�O�//ci�al Use eOOnly/ • i cc77 �['iJ Permit No. \. Y�'C^ ✓[SQ�' eparlmrnt o/Mrs&,vices . 711 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS -Rev. 1/07] - t7eave blank) ------- APPLICATION FORPERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ,527 s• 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMA7707V Date: 0 City or Town of: YARMOUTH To the Inspector of Wires: By this application the lmdersigned gives notice of his or her intention to perform the��ele�n'cal work described below. lic . Location(St-eat&Number) /3 a9'' RA ca-Fr 10 6 5- _lee SA�/�_ '_,_,c_ Owner•orTenant Telephone No. h/ Owner's Address S's.....-e _ Is this permit in conjunction with a building t� RI, • p Yes ❑ No (Check Appropriate Box) Pm-pose of Building gj t/C g,A,N tint,Authorization No. Existing Service VIM Amps J/ c 1..7 ViVolts Overheadr Undgrd ❑ No.of Meters L �� z 'qew Service Amps / Volts Overhead❑ Undgrd ❑ NO. of Meters _ W en 2 o Number of Feeders and Ampacity . S • • , P G Ler 0 „Scv) /W L e tete h L Y,,a I.,ocation and Nature of Proposed Electrical Wor-• et/ r _�I (d" �` /Completion of the foliowine table may be wowed by the Inroect°r of rer. o o z o.of Recessed Luminaires No.of Cerl�Susp.(Paddle)Fans • No,of Total Transformers }CVA w‘i3 iii Z Vo. of Luminaire Outlets No.of Hot Tubs Generators • ICVA ' i5 , -m i�Vo. of Luminaires Swimming Pool Above ❑ In- 'No.of emergency Ltghnng — srnd arnd. 0 Battery Units No. of Receptacle Outlets . No.of Oil Burners IFIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and i Iaitiatina Devices No.of Ranges No. of Air Cond. Tons No.of Alerting Devices • Heat PumplNumber I'Tons I KW No.of Self-Contained O Totals:I Detection/.Ajertine DevicesNo. No.of Dishwashers Space/Area Heating KW' LoralMunicipal Q Connection 0er No. of Dryers Heating Appliances KW Security Systems:• = No. of Water No. of No.of Data Wior nDevices or Equivalent Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent N OTHER: Attach additional detail t municipal policy.)or as required by the Inspector of Weer. Estimated Value of E tui - Wor]` (When required by mtuici el Work to Start p Rule� 7 % Inspections to be requested in accordance with MEC Rule 10,and upon completion. 0 INSURANCE Ca • - GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless • LA 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: INSURANcy7 BOND 0 OTHER 0 (Specify:) '% I cat*, under the pains and pe s ofperfusy,at the information on this application it true and complete• FIRM NAME:�OD2Ot�4) c/ LIC.NO.: 2•�j'0 Licensee: OL9 Coy,A/ Signature 2. LIC.NO: (If applicable,enter" empt"in the licems i mz line.) Bus.TeL No: Address•. re? dor Hi y5tile f ue .1 ) j,°3 j `Per M.G.L.c. 147,s.57-61, c work requires _ Alt.TeL No. OWNER'S INSURANCE WAIVER I am aare that theLLiccensePublicos not have the liabilityLin-insurance No. lly required by law. By my signature below,I hereby waive this requirement. I are the(check one) coverage hors age Owner/Agent 01 owner ❑owner's ag L Signature Telephone No. I PERMIT FEE: $ I -