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Home My WebLink AboutE-19-7106 Commonwealth of Official Use Only citisi. Massachusetts Permit No. BLDE-19-007106 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•6/18/2019 City or Town of: YARMOUTH To the Inspector of Wires: 93•13 r 3 a U ( "E0 By this application the undersigned gives notice of his or her intention to perform the electrical work des bed below. ` Location(Street&Number) 589 WEST YARMOUTH RD . ( l4 14 f}- '-Q Owner or Tenan Telephone No. Q ,1) Owner's Address , , also Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Purpose of Building Utility Authorizati n No. 2330452 Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Trench&conduit for future services. 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 0 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: Licensee: Matthew Kane Signature LIC.NO.: 55328 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:35 Harvard Street, South Yarmouth Ma 02664 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 a(( 66? k- r Commonwealth of//lassachu.sett5 • Official Use Only■ —, Permit No g — ,_...._____.„,,,, ;---=--==." - " Oc L Parfmaito1 Serviced"-Z r BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank) • ADDI Ir•ATlrv►t rnn .ems. R.. ----_-__ - a�:_ i:de.. "aria t I v I-CIZFOKIVI CLCI: l RICAL 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: (o-t?, —I 7 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) ` g-.) l S; /A/2,44 M 'P/ R-0.4 Owner or Tenant i o, e....-1-. ra-Sfr-c, Telephone No.Sg 3g r 12 8 Owner's Address 521 s T �. 4 „U,l.�r ,Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building jug."+ R^5� Utility Authorization No. t 33r2 i5a Existing Service Amps / Volts Overhead ❑. Undgrd gr ❑ No.of Meters New Service Ci- 47) Amps /10/at Volts Overhead ❑ Undgrdp No.of Meters Number of Feeders and Ampacity ,A Location and Nature of Proposed Electrical Work: Completion of the following table may be waived by the Inspector of Mitres. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Total Transformers gVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No. of Luminaires Swimming pool Above ❑ In- No.of Emergency Lighting - erred. grad. 0 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. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons f KW No.of Self-Contained 1 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KWLocal Q Municipal Connection ❑ � No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 1� Attach additional detail if desired;or as required by the Inspector of Wires. Estimated Value of Electrical Work 1 (When required by municipal policy.) Work to Start: ,.. ('),( I Inspections 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: LIC.NO.: Licensee: �`` k'¢N Signature �--- (If applicable,enter exempt in the license number line.) LIC.NO.: Address Bus.Tel.No.: — T j *Per M.G.L. C. 147, S.57-61,security work requires Department of Public SafetyAlt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By sigma a belo Owner/Agent w.,-I-hereby waive this requirement. I am the(check one owner 0 owner's a enL 0.1 Signature �q - Telephone No.eb -”0p -j ZgLD PERMIT FEE: $ SO"'