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Home My WebLink AboutBlde-19-006592 Commonwealth of Official Use Only '1%11. Massachusetts Permit No. BLDE-19-006592 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:5/21/2019 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) 730 WILLOW ST Owner or Tenant ROACH RAYMOND T Telephone No. Owner's Address ROACH CATHERINE H, 29 MAITLAND ST, MILTON, MA 02186 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 for two split NC systems. 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. 2 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: 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 CIS 6(l(q �^ T Commonwealth of Maz.lachu.seitz cial Use Only cc� cc7� �i Permit No. dffiCis''''65SCI 2.• - ;t-- : 1Japarfmcnf of.7-ire Serviced 1 ' Occupancy and Fee Checked ",��;:."` BOARD OF FIRE PREVENTION REGULATIONS iRev. 1/07] . (leave blank) `' 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 INFOPJ TIOA) Date: �\ City or Town of: YA.RMOUTH To the Inspector of Wires: 1 • V By this application the pndersigned gives notice of ' or her intention to perfo the electrical work describ below. ! Location (street&Number) 34 Elul -S'f6�e�f 'oc, Jed' Owner or Tenant ,tle..._ P� Telephone No. Owner's Address f Is this permit in conjunctio with a ufdi ernut? Yes E No' (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service/67f Amps /0-4/ Volts Overhead elm' Undgrd ❑ No.of Meters , New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity WI r - _ 7LTAfi_ /4 ----7.jzi. Location and Nature of Proposed Electrical Work: ______c , / --- — - ( letion o 0 mp f the following,table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-Stzsp.(Paddle)Fags No.of Total Transformers ICVA No. of Luminafre Outlets INo.of Hot Tubs Generators KVA No,of Luminaires (Swimming Pool Above grad. 0 (B In- No.ofattery L Unitsmergency Ltghung grad. No. of Receptacle Outlets No.of Oil Burners !FIRE AIAR_MS INo.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 Number Tons KW [No.of Self-Contained Totals: I !Detection/Alertins Devices No.of Dishwashers Space/Area Heating KW' LocalMunicipal Q Connection Other No.of Dryers Heating Appliances KW Local Systems:*"ices or Equivalent No.of Water KW No. of No. of Data Wi No.of" ivaient Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: Na.of Devices or Equivalent OTHER: 4.1d �ttach additional detail f desired or as required by the Inspector of lyres. Estimated Value of El ctric Work _27, (When required by municipal policy.) Work to Start: 10/I Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C 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. CHECK ONE: INSURANCE !r BOND 0 OTHER 0 (Specify:) ` I cerii,fy, tinder the pains and'enables of erjury,th the in ormation on this application is true and complete. \ FIRM NAME: �Q91 �� iIf- js �> ,mod 'ti �C LIC.NO.: Licensee: Signature �.;�'�_ LIC.NO.: ��C�' (If applicable, enter" t' in the license number line) Bus.TeL No.: n p/► /�g�/ Address �Y T'�� ®/� Alt.TeL No.• O'�U" P"7 / J *Per M.G.L. a. 7,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. vcc — OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normallyrage — SOwned Agent by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's apL�L I Signature Telephone No. PERMIT FEE: $ D '�