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HomeMy WebLinkAboutBLDE-19-002360 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19 002360 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:10/22/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertomt the electrical work described below. Location(Street&Number) 198 SOUTH ST Owner or Tenant CHARLES WHITE MANAGEMENT INC Telephone No. Owner's Address 330 COMMONWEALTH AVE.BOSTON, MA 02115-2117 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (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: Replacement boiler. 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 1 No.of Detection and initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Ifeat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 ❑ 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) ❑ owner 0 owner's agent. Owner/Agent Signature r Telephone No. PERMIT FEE:$50.00 (C)V“--aa- "(t Lk((a " l.ommon,ueaLUs of/t/a56¢eaLFi • O�ajalJ.lctse O _ �o T!-tn _ 2.,,artmenf oi k.Serviced . Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07j (leave blank) • '�, APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK . All work to be performed in accordance with the Massachusetts Electrical Code(MEC,527 C 12.D0 (PLEASE PRINT IN INKOR TYPE ALL INFORMATION) Date: /6/IS /J • p J City or Town of: YARMOUTH To the Inspector of ires: (/" . By this application the lmdersiped gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) / S6f� �'�/ Olt" ( Owner or Tenant � ft9 �� W1Telephone Na. IOwner's Address I Is this permit in conjunction with n ding permit? Yes ❑ No� (Check Appropriate Box) / i, I Purpose of Building Utility Authorization No. CH Volts Overhead❑ UndgrdExisting Service/00 Amps 490/b'jtw Volts Overhead [ Undgrd I: No.of Meters L New Service Amps / ' .1 ❑ No.of Meters Number of Feeders and Ampacity 1:N i Pe r-of 'st > p / Q i Location and Nature of Proposed Electrical Work: ll _ ©� e��J MI 4}- •.L UJ 4- f Min...__.._. ... Completion o/the foilawbuy table may be wived by the Irapecbr of Weee c�f) < No.of Recessed LuminairesNo.of Total 041a. INo. of Cer7.Susp.(Paddle)Fans Transformers KVA in "�'1 ! L No. of Luminaire Outlets INo.of Hot Tubs Generators • KVA ' 0 CT' O No.of Luminaires pool Above In- No.of nmergeary Ltghun • - �- (Swimming fid. ❑ ernd. ❑ IBattervUnitsal Ctti g - i No.of Receptacle Outlets No,of OR Burners FIRE ALARMS 1No.of Zones T ne 1-17 11' No.of Switches No.of Gas Burners Na.of Detection and — Initiating Devices Total V No.of Ranges INo.of Air Cond. Tons No.of Alerting Devices _ No.of Waste Disposers Heat Pump Number ons IND.of Self-Contained Totals:I I TI KW lDeteetion/Alerting Devices • No4 .of Dishwashers Space/Area Heating KW' Municipal IPpeal❑Connection 0 er No.of Dryers Heating Appliances KW �ecurity Systems:• No,of Water No.of Devices or Equivalent Heaters KW ('o. of No.of Data Wiring: 0 Sins Ballasts No.of Devices or Equivalent J No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: Na.of Devices or Equivalent ,�, 0111L�R: • 1 ) Attach additional detail ifdesired or as required by the Inspector of Pres. c L` Estimated Value of El cal WorE 39� (Wben re b municipal policy.) Work to Start Value/of f`7//� Inspections to be requested in accordance with MEC Rule 10,and upon completion INSURANCE CO RA(G�E: 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 t, undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. V) CHECK ONE: INSURANCE p1 BOND 0 OTHER 0 (Specify) I ceriifyr under the pains��and f e�n'alAes ofpvl w75 that formation on this application is true and complete. FIRM NAME:ccr►t•4t/1✓c o9.r 5 C )11, _ LIC.NO.: �So� 0 Licensee: .0 O /J Signature y)..c^ _ (If applicable,enter'• �f�l" /� LIC.NO.: f in the!ic a number line.) Bus.Tel.No.: Address: 77 Qjr'/�/'�J f, - (e � .LLL J *Per M.G.L. c. 147,s.57-61, curitysCwork requiresff Alt Tel.No:Z% Department of H6bGc Safety"S"License: Lie.No. - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement. 1 am the(check one)0 owner 0 owner's agent r Owner/Agent Signature Telephone No. I PERMIT FEE: S 1C:0