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Home My WebLink AboutE-20-193 7V‘ Commonwealth of Official Use Only ovti Massachusetts Permit No. BLDE-20-000193 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: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 34 ARLINGTON ST Owner or Tenant LIBERTY ANNE M Telephone No. Owner's Address 34 ARLINGTON ST,WEST YARMOUTH, MA 02673 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 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 3 condensers&two air handlers. 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- ElNo.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 Initiatine 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 Totals: Detection/Alertine 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 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 C 8— SI 7/iq/,q �� l,omrnoruusatth o�///a6saci Official Use Only , �{ie - --- ( 2 -0�== 2eparinuutt al ire J Permit No.� Serviced =i= ' Occupancy and Fee Checked _ BOARD OF FIRE PREVENTION REGULATIONS iA Rev. 1/07] @leave blank) j` APPLICATION FOR-PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.D0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: YARMOUTH To the Inspector of Wires: 0 e By this application the undersigned gives notice of his r her inte 'on to perfo the ele ' work described low. Location(Street&Number) �� C� aov, j r G l Owner or Tenant j�/'t J �� a Telephone No. /`/ Owner's Address T,�,,."_ Is this permit in conjunction with a b -ing permit? Yes No OU/��`', tl ❑ ❑ (Check Appropriate Box) Purpose of BuildingUtility Authorization No. Existing Service Amps / Volts Overhead c�\ �5 ❑. UndgrcX No.of Meters v�► New Service Amps / Volts Overhead❑ Und d Q �' l gr ❑ No.of eters Number of Feeders and Ampacity (Nl ,V r, )cle4p5. � Location and Nature of Pr posed Mc 'cal Work: /i�N Completion of the following table may be waived by the Inspector of Wires. fM__ No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Total 1 Transformers KVA No.of Luminaire Outlets _No.of Hot Tubs Generators KVA )1t No.of LuminairesSwimmingpoolAbove ❑ Ia- ❑ Ba of Units cy Ltghung - In- Battery IInews No.of Receptacle Outlets No.of Of Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: I I + Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal,Local❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Heaters Data Wiring: Signs Ballasts No.of Devices or Equivalent cl U No. Hydromass age Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: _ ,c.. Attach additional detail if desired or as required by the Inspector of Wirer. Estimated Value of Elec .ca Work (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO GE: 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 BOND 0 OTHER ❑ (Specify:) I certify, under the p�n�-/��Jties ofperIu ,that the info rmation on is lication is true and complete. 6 FIRM NAME: rd-(.5- / Licensee: LIC.NO.: �o�(� ignature IC.NO.: �/�1 (If applicable,enter "es pt"in thi nse rru r fine �� Address. lGilr 1y Bus.Tel.No.: J` 'Per M.G.L. c. I 7 s.57-61,sec work re f Alt.Tel.No.: ty quires Department of Public Safety"S"License: Lic.No. �z 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)❑owner ❑owner's agent. Owner/Agent 1 Signature Telephone No. I PERMIT FEE: $ I