The URL can be used to link to this page

Home My WebLink AboutBlde-20-000190 or Commonwealth of Official Use Only /t-. Massachusetts Permit No. BLDE-20-000190 ;�� " 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•7/12/2019 City or Town of: YARMOUTH To the Inspector of Wires: 4 i q 1 Gn6— 11007 By this application the undersigned gives notice of his or her intention to perYQrm the electrical work desc " below. Location(Street&Number) 184 SOUTH SEA AV � bUIN Owner or Tenant SLOE Telephone No. Owner's Address E - : - - 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 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring of disconnect&condenser. 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. grd. 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 Ini.tiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 Siens 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 Cts ef-> fi9 Comrnoncvsatth o/?asdachudctts Official Use Only it —N �,,_:, cc�� c-� n20 0� srlr .LJaParfinanf of yira J PermitNo.� O n _ Serviced Ot V\ r� f • A BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked rRev. 1/07] (leave blank) O\J < APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK kAll work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 12.D0(pi j (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: �� 9' City or Town of: YARMOUTH To the Inspector f Wires: A- By this application the pndersigned gives notice of his or her in ention t perform a electrical w rk described below. lie(% - Location (Street&Number) . sou a ,L - ' Owner or Tenant .6Cf Op,p4 e t----- Telephone No. -� Owner's Address f/ -- -�7 Is this permit in conjunction th a ildin t? Yes / �' c%% /� , ❑ No ❑ (Check Appropriate Boz) Purpose of Building �(fJ Utility Authorization No. Existing Servic�d'e) Amps /) /7[/4 Volts Overhead Undgrd / 6 v"z �' ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd No.of Meters Number of Feeders and Ampacity �.d�It ti-e 2 ,P4.5-)/.S— � Location and Na re of Proposed Electrical Work: �/ 0 1 �' �� c� (, ",7.- COletion 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 Swimtnla pool Above In- No.of Emergency Lighting• g _rad grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones 1 No. of Switches No.of Detection and`F� No.of Gas Burners lll''' ' Total Initialing Devices No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons H KW No.of Self-Contained Totals: Detection/Aler•ting Devices No.of Dishwashers SpacefArea Heating KW Local Municipal ❑ Connection ❑ � No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of Heaters Kam' 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 OTHER: yAttach additional detail if desired or as required by the Inspector of Wires. Estimated Value o El ;11 Work J dd (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. 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. L CHECK ONE: INSURANCE5BOND ❑ OTHER 0 (Specify:) I certify, under the pains an penalties of perjury,that the info ation on this application is true and complete. Ad FIRM NAME: ,1...r :✓LIC.NO -�4 � r^Licensee: .r --�_ ��/"/�-/�^„ Signature LIC.NO. �� 1/ (If applicable,enter "ere ip t i ease number line. Address: X' ( . Bus.Tel.No.: _ f� I� J Per M.G. . C. 147,s.57-61,securitywo requires // Alt.Tel.No. � or f-W�, Department of Public Safety"S"License: Lic.No. �' OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally 5 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. I PERMIT FEE: $