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Home My WebLink AboutBlde-20-001564 Commonwealth of Official Use Only • Permit No. BLDE-20-001564 , 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:9/20/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perto7 the electrical work described b to Location(Street&Number) 3 CUTTER LNr N( & / � Owner or Tenant ROMANS ROBERT F TR Telephone No. Owner's Address V C L RLTY TRUST, 3 CUTTER LN,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check CL�M Appropriate Box) Purpose of Building Utility Authorization No. E gh_0t�02.1.6 9(Z3/f7 Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace service. 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/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 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: $50.00 e` 1 Ccco�`rnn�oauisaith ofc-///a ac ifs ,. • /�OOfficial Use Only . � 'i 1JsParfinsni o f emirs Jsrvics Permit No. l.V ` � 1f- BOARD OF FIRE PREVENTION REGULATIONS Occupancy 1/07) and Fee Checked OP [Rev. Ii07) (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 INFORMATION Date: 9 /9//7 City or Town of: YARMOUTH To the I ector of Wires: By this application the undersigned gives notice of . or her intention to perform the electrical work described below. Location(Street&Number) G f / A.A N--P Owner or Tenant M )0 i se, t� 11 A - ,. �v l/f 1<, Telephone No. Owner's Address S" � � �q�yh �, S.!�� 2�d,� Is this permit in conjunction with a building permit? Yes ❑ No [L Check Appropriate E)` ( pP priate Box) Purpose of Building / P.�y,�,1 Utility Authorization No. T,p�,r, • Y'-` Existing Service Amps F / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Zc)O v Amps /2 / p29°Volts Overhead Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: `, �l t.�. J eje V LLC...) Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cea1."Susp.(Paddle)Fans No.of Total Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimmia Poo, Above In- No.of 1 mergency Lighttag -6 grind. ❑ ernd. ❑ Battery units _ No. of Receptacle Outlets No.of OH 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. 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 Loth❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* • No.of Water No.of No.of Devices or Eq al uivent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent rt"•r Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: p O c� .�,=,__ (When required by municipal policy.) Work to Start: 11 ) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCEBOND ❑ OTHER 0 (Specify:) I ceriz;fy, under the pains and penalties o ��') f rj',that the information on this application is true and complete. FIRM NAME: Z )a C. 6,4 r, v-) Licensee: G �� LIC.NO.: /l4 . 4'/ ri Signature LIC.NO.:c (If applicable,enter " in the license tuber li Address: �Jb QN NJ � `% Bus. •Tel.No.: - .a3 0.; J *Per M.G.L. C. 147,s.57-61,security work requires D artmen of lc Safety"S"License: AltLici�No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability 5 S required by law. By my signature below,I hereby waive this requirement I am the(check one 0 owner low normal - Owner/Agent ❑owner's a eat Signature. Telephone No. PERMIT FEE: $