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HomeMy WebLinkAboutBlde-20-000140 Commonwealth of Official Use Only Permit No. BLDE-20-000140 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:7/10/2019 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 el cal work es ed l w. Location(Street&Number) 101 ROUTE 6A 0 ��/'� Owner or Tenant TILLY SVEN Telephone No. Owner's Address OCONNOR BETSY, 101 ROUTE 6A,YARMOUTH PORT, MA 02675-1709 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: Install sub panel,air cond., receptacles for window A/C's. 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/Alertinc 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: Jack W Griffin Licensee: Jack W Griffin Signature LIC.NO.: 418 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:26 JOANNA DR, S YARMOUTH MA 026641339 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:$80.00 / R 1 d\ += Commonwealth of/�/a.ddac ffd Official Use Only A. - i/ cam. c� �c _ ar 2)eparfinent of.emirs Serviced Permit No. t/ Li- ==s'= If__ -r, BOARD OF FIRE PREVENTION REGULATIONS Ov�pancy_and Fee Checked $� (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK -.. All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CIvfR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: j/jD//9 la City or Town of: YARMOUTH To the Inspector of Wires: 't• By this application the ttmdersigned gives notice of his or her intention to perform the electri work,described below. Location(Street&Number) J©/ R0 u- 6 4 0 fcle_, "P�)ns ,N Owner or Tenant -Ay t Ac7;24 6erild Telephone No. eOwner's Address 5A •tom K _, PP Is this permit in conjunction with a building permit? Yes ❑ No (Check A ro riate Box) '� __ P Purpose of Building Utility Authorization No. **... Existing Service Znd Amps /ZO/c9 LI aVolts Overhead D Undgrd❑ No.of Meters e New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: --, y S e6.9 0 -.?607.,✓C. pew__ tA),,,h�P a vs-) A • e. v�t17..S 7svZ PA--A4. Completion tithe followingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell Susp.(Paddle)Fans No.of Total Transformers KVA _ No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting crud. ❑ _rnd. ❑ Battery units No.of Receptacle Outlets No.of Ott Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas Burners 'No.of Detection and Initiating Devices No.of Ranges No. of Air Cond. Tom No.of Alerting Devices 1 No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: f Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal I'o� Connection I=1 °tiler No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent Heaters ' Data Wiring: Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs Telecommunications Wiring: y g No.of Motors Total HP 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: 7 J o J if Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify.) I certify, under the pains and penalties of erjury,that the information on this application is true and complete. j�` FIRM NAME:t— y. 6 Y,1 i" LIC.NO.: Ma ci ) Licensee.• ro r3f$ 1) Si azure 1 a licabl n LIC.NO.: P s9/9 (I pP e }e apt"in the license number the.) / Bus.Tel.No.: 404 / 0\j Address: �v J bni^+,'''�'�6 v 1z .v t ,lj&ZA D• , I� faltiv> Alt.Tel.No.: J *Per M.G.L.c. 147,s.57-61,security work requires/Department of Pu.'. Safety"S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n— o — y required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's t Owner/Agentagent. I Signature Telephone No. {PERMIT FEE: $