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Home My WebLink AboutBlde-20-000623 Commonwealth„Atm' Official Use Only of Massachusetts Permit No. BLDE-20-000623 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:8/2/2019 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) 34 TURTLE COVE RD Owner or Tenant KNOWLES ELIZABETH A Telephone No. Owner's Address 24 CONCORD RD, LONGMEADOW, MA 01106 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: Split A/C system. 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 ❑ 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 stc;f4 r //�� yyy�j/� //. Comnw w.alth of///aachu�altd vial Use�O/nnll�y git 2eparfinarrf a l5ire S! Permit No. tp rvittd—_. a ancy BOARD OF FIcup RE PREVENTION REGULATIONS O`. 1107] and Fee Checked (leave blank) AUjiiell APPLICATION FOR:PE — RMfT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME 527 12 00 W (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: V a- (- City or Town of: YARMOUTH To the Inspector of Tres_ By this application the undersigned gives iotice of his or her intention to perform the electrical work described below. r$Q,, __.�•'�.'.` Location (Street&Number) 3—! `��re �v-e_ p _ ( Lit? ? —r f- 1 .. -- ;i ' er or Tenant �/ s L M d�,�) (ef� 1" Telephone N . f�GiN er's Address — �_ {RS �`~' 4 s permit in conjunction with a uildin permit? Yes ❑ No (Check Appropriate uj r, i i ose of Building e;l Utility Authorization No. 0 f \ 'ng Senice/CO Amps /� I j Volts Overhear Undgrd /� W \J -� o '%LJ 1;� ❑ No,of Meters / ervice Amps / Volts Overhead`❑ Undgrd❑ No.of Meters Mink r of Feeders and Ampacity I F Location and Nature of Proposed Electrical Work: 7 Completion of the follawinvable 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 ICVA v No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grnd. stud- Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS ,No.of Zones DO No.of Switches No.of Detection and No.of Gas Burners InitiTotal 1ating Devices No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Q Municipal Connection 0 other U` No.of Dryers Heating Appliances KW 'Security Systems:* No.of Water No.of No.of Devices or Equivalent ` Heaters ' No. of Data Wiring: Signs Ballasts _ No.of Devices or Equivalent t No.Hydromassage Bathtubs OTHER: No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent .. Attach additional detail f desired or as required by the Inspector of Wires. Estimated Value of lec 'cal Wort--L� c (When required by municipal policy.) k Work to Start: 02 ` Inspections to be requested in accordance with MEC Rule 10,and upon completion. tO INSURANCE CO IJE: Unless waived by the owner,no permit for the performance of el ectrical work may issue the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent, The ss il undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. Q. CHECK ONE: INSURANCE. BOND 0 OTHER 0 (Specify:) ix I certify, under the pains and penalties of perjury,that the information on this application is true and complete .A NAME: O D 't SdIJ.f 0le�r t G LIC.NO.: /7/5.270 Licensee: '4 S eAr Signature (If applicable,enter "er mpt": t jicensenumber ' /�1' e.) + LIC.NO.: Address: 37 t�/ '& '7 f a/Ve n �f rn9 Bus.Tel.No.: J "Per M.G.L. c. 147, s.57-61,sec rk requires Department of Public Safety1S"License: Alt.Tel.No.. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement I am the(check one ❑owner 0 owner's a ent. + Owner/Agent Signature al - Telephone No. PERMIT FEE: $