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Home My WebLink AboutBlde-20-000340 i 0-' Commonwealth of Official Use Only t:` ` Massachusetts Permit No. BLDE-20-000340 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:7/22/2019 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) 9 MAURA RD Owner or Tenant DARCY BRIAN J Telephone No. Owner's Address DARCY SUZANNE J, 132 DALE ST,WALTHAM, MA 02451 Is this permit in conjunction with a building permit? Yes ❑ 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 CI No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for air conditioners 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. Batten'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 1 Initiating Devices No.of Ranges No.of Air Cond. 3 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained ft 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: 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 '. ,,,,,y7 Common-wealth of///assae ffs _ ,Official Use Only, f '1�i-,t c-� �7� Permit No.�-U 3�'U --e!=_ 1Japartmenf o�emirs Services BOARD OF FIRE PREVENTION R - -- ` REGULATIONS Occupancy and Fee Checked "�'` jRev. 1/07] ot (leave blank) APPLICATION FOR-PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code c_V-- (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: >>s2 1 z.ofl Cityor Town ��1� of: YARMOUTH To the I ctor of Wires: A if r 1By this application the r,tndersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 9 �1 - �c Owner or Tenant �+qi✓ 962 Telephone 11.4.6 Owner's Address �'�+7,—�+ 7 � ` Is this permit in conjunction with a b ilding permit? Yes No �-5�-9 CAA) ❑ (Check Appropria Purpose of Building ,v,y'i Utility Authorization No. Existing Service/D el Amps/,),o izaV40, Volts Overhead Undgrd❑ No.of Meters / New Service Amps / Volts Overhead❑ Undgrd g E No.of Meters rr,, Number of Feeders and Ampacity 4/ lead 4--C....- CI'i y jab i /i,}' ��' Location and Nature of Proposed Electrical Work: ___1-1- m /.- 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 h:mergency Lighting crud. grnd. Battery Units No. of Receptacle Outlets No.of OH Burners FIRE ALARMS [No.of Zones No.of Switches No.of Gas Burners 'No.of Detection and InitiatingTotal _Devices Qi No.of Ranges No. of Air Cond. Tons No.of Alerting Devices r No.of Waste Disposers Heat Pump I Number I Tons H KW No.of Self-Contained Totals: Detection/Alerting Devices 4 No.of Dishwashers Space/Area HeatingKW Municipal L0� ConnectionOther ii No.of Dryers Heating Appliances KW, Security Systems:* �'\ No.of Water No.of Devices or Equivalent No.of Heaters KW 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 t q OTHER: _ ./ Attach additional detail if desired or as required by the Inspector of Wires. �� Estimated Value of lec cal Work: i (When required by municipal policy.) Work to Start: 7 �r/ ' Inspections to be requested in accordance with MEC Rule 10,and upon completion. Ilk INSURANCE 0 RAGE: 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: INSURANC BOND ❑ OTHER ❑ (Specify:) I certify, enalties o , under the pains an P f perjury,th the in rmation on this application is true and complete. FIRM NAME: d► .Sd:�t i'Z LIC.NO.: t j�o Licensee: Signature LIC.NO.: G' (If applicable.enter" mpt"fn he license nu ber liven . Address: Bus.Tel.No.: J "`Per M.G. . c. 14 , s.57-61,s ' work requires Department of Public Safe4"S"License: Alt Lic.NTel. o. — 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. I am the(check one)0 owner ❑owner's agent Owner/Agent Signature Telephone No. 1 PERMIT FEE: $ �� I