The URL can be used to link to this page

Home My WebLink AboutE-19-6983 fiAor of Official Use Only Permit No. BLDE-19-006983 Massachusetts 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:6/11/2019 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) 3 TURTLE COVE RD Q76 Sol 72 Owner or Tenant REYNOLDS JOHN D Telephone No. Owner's Address REYNOLDS JUDITH A, 3 TURTLE COVE RD,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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for mini split. 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. 1 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 ❑ 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:$50.00 MC, £7 (2/9 1 Ke t Commonwealth of///a aciuc�ffs Official Use 1 ''_=_- —_ c7 n C Q - 3 rn� = aparfmanf o f.7-ire&rvice$ Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked tev• 1/CM (leave blank) APPLICATION FOR-PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: (ham )'527 1�.00 \ City or Town of: yARMOUTH �7 19 To the Insp ctor f Wires: By this application the undersigned gives no 'ce of is or her intention to perform,,the electrical work described below. Location (Street&Number) it• (--O d4 /,( �7 , Owner or Tenant Y �v l �e��t/�7 S Telephone No. O a6"(�A O'vner's Address Iithis permit in conjunction with a building permit? Yes ❑ No/� ❑ (Check Appropriate Box) `'' J Purpose of Building Utility Authorization No, . O L) , Existing ServicOQ Amps/�O �!�/a Volts Overhead Undgrd -, gr ❑ No,of Meters 4 =-, New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters _Number of Feeders and Ampacity , .//l Q lam. 4 l .- _. _._ ,_Location and Nature of Proposed Electrical Work: 0/7f/A1/ --,CP/ZY--- Completion of the followingtable may be waived by the Inspector of Wires. \f No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans N0 °f Total Transformers KVq No. of Lumiaaire Outlets No. of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- "No.of Emergency Lighting - 1+ arnd. crud. ❑ Battery Units Nt No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and J No.of Ranges ' % No.of Waste Disposers Total Initiating Devices No of Air Cond. Tons No,of Alerting Devices Heat Pump l Number Tons )KW No,of Self-Contained Totals:I I Detection/AlertIna Devices - `l No.of Dishwashers Space/Area Heating KW Municipal Loral❑ �• ❑ Other No.of Dryers HeatingAppliances Security Systems:* V PP KW ty D No.of Water No.of No.of evices or Equivalent Heaters KW Signs Ballasts Data Wiring: No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: - No.of Devices or Equivalent / Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of E ec . al Work 7 (When required by municipal policy.) Work to Start: 7 a Inspections to be requested in accordance with MEC Rule l0,and upon completion. 1 , INSURANCE GE: Unless waived by the owner,no pelrnit 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 I♦440:0ND ❑ OTHER 0 (Specify:) I certrfy, under thepains and,-n � �') • s of pe ury,that the information on this application is true and complete.FIRM NAME: O- `( '0r Licensee: LIC.NO.: �J o�9 ��✓✓✓ cr �O S (If applicable,enter"es p the licens tuber ' )� ignature IC.N O.�?'/ Address: et"? �G Bus.Tel No.: n? j "Per M.G.L. c. 147,s.57-61 ec ty work requires Department of Public SafetyAit,Tel.No.: � y OWNER'S INSURANCE � "S"License: Lic.No. �c AIVER: I am aware that the Licensee does not have the liability insurance coverage n�— required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner ❑owner's a ent Owner/Agent al Signature Telephone No. PERMIT FEE: $