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Home My WebLink AboutBLDE-20-000420 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-000420 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 IN INK OR TYPE ALL INFORMATION) Date:7/25/2019 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) 132&134 WEST YARMOUTH R Owner or Tenant HOLT DAVID R Telephone No. Owner's Address HOLT NANCY J,207 COACHMAN LANE,WEST BARNSTABLE, MA 02668 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 ❑ 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 to service after storm. 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 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/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: KUNG-PO TANG Licensee: Kung-Po Tang Signature LIC.NO.: 52286 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:518 COTUIT RD, MASHPEE MA 026492351 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 �� ri2hi9 C.ommo cwsaLth o/Ma.�644ade J Official Use Onl .20 i= .� O r --._!9i- -= .11a arlmenE of.firs Services Permit No. '� L BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked .-�D [Rev. 1/07] [leave blank) 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: 7, z S L _.._ City or Town of: YARMOUTH To the Inspector of Wires: v J By this application the undersigned es notice of his or her intention to perform the electricalrwork described below. Location (Street&Number) 15Z - 1 34L -titles( ` a..y,n t f i .t I ,( / itr--'- v� or-set"cr.� Owner or Tenant Telephone No. . Owner's Address ` Is this permit in conjunction with a buildin permit? Yes ❑ No ® (Check Appropriate Boz) V) _= Purpose of Building Re �5,q , T iG Utility Authorization No. Existing Service AmpsVolts Overhead ❑. Undgrd 1‘,.... / ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd gr ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: a Sei-kc e re e t' i,je ( c Lwr 7,1 S>J r/n Completion of the followinvable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cet1.-Busy.(Paddle)Fans No.of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Pool Swimming Abovearnd trnd. ❑ B In- No.ofattery!✓timergency Lighting nts No.of Receptacle Outlets No.of Oil Burners FERE ALARMS INC.of Zones • No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No..of Air Cond. To No.of Alerting Devices tal No.of Waste Disposers HST p I in_ Number `Tons I KW No.of Self-Contained • 1 i _Detection/AlertDevices No.of Dishwashers Space/Area Heating KW Local❑ Muaicipat r Connection ❑ Other i s tl No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring C(1 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: 4, Estimated Value of Electrical Work: (When required by municipal policy.) V1 Work to Start: —1 —ZJ 4? fictions to be requested in accordance with MEC Rule 10,and upon completion. 4 d 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 -"i- undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE g BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and e P nalties of perjury,that the information on this application is true and complete. FIRM NAME: / � LIC.NO.: Licensee: 6`.. ' Signature / (If applicabl .€4r, . .. "in th-be . mber l he.) LIC.NO.: Z Z fe • Address: L i Q f A.`t` _ � A Q 269 Bus.TeL No.:Z j Per M.G.L. C. 147,s.57-61,security work requires D .: .. ent of Public SafetyAlt.Tel.No.: — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilityLin.No. required by law. By my signature insurance coverage no-rtn S Owner/Agent below,I hereby waive this requirement I am the(check one 0 owner ❑owner's a eat Signature.- Telephone No. PERMIT FEE: $