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Home My WebLink AboutBlde-20-001024 or Nu Commonwealth of Official Use Only fill Massachusetts Permit No. BLDE-20-001024 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:8/26/2019 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) 30 FISHING BROOK RD Owner or Tenant GATELY DEBRA R Telephone No. Owner's Address 10 PLYMPTON AVE,WALTHAM, MA 02154 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: Install receptacle for water heater. 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 1 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. 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 ❑ 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: KUNG-PO TANG Licensee: Kung-Po Tang Signature LIC.NO.: 52286 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:518 COTUIT RD, MASHPEE MA 026492351 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 (9('r`t c aGA (c og ' \- ) ' q in _:_-_- COMMOR0/00 th o/Ma06041.146016 • Official Use Only -- li = 2eparfinent of Jzre Services Permit No. &-- `V 7-4 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked , Rev. I/073 (leave blank) L E APPLICATION FOR:• PERMIT TO PERFORM ELECTRICAL WORK c All work to be performed in accordance with the Massachusetts Electrical C),527 I2.D0 `� ,. (PizAs E PRINT IN INK OR TYPE ALL INFORMATIONq Date: Z / t ��l City or Town of: YARMOUTH To the Inspector of Wires: Lilto . ;' 3y, application the pndersigned gives notice if his or h tentio to pe rm the electrical work described below. ) ,o Lion(Street&Number) , D 1� !,5 if 1 l� 3 Ov* . It -----d- -••---1Qmier or Tenant p, Telephone No. - --- Orw—'ner's Address Is this permit in conju 'on with a building permit? Yes rp ��el �� ❑ No ,� (Check Appropriate Box) Purpose of BuildingUtility Authorization No. Existing Service Amps / Volts Overhead ❑ Und grd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd t;z' ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ° 0 n d c/ lVit•_1/_ - ,/ _ 1'e4.- Completion of the following table may be waived by the Inspector of Wirer. No.of Recessed Luminaires No.of Cet1.-Susp.(Paddle)Fans No.of Total Transformers KVA _ No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above El in- Ho,of l mergency Lighting - grad. crud. ❑ Battery Units No.of Receptacle Outlets r No.of Oil Burners FIRE ALARMS INo.of Zones V No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No. of Air Cond. Total C� 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 Loral❑ Municipal Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent of Heaters ' No. No.of Data Wiring: v1 Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommonications Wiring: - >j OTHER: No.of Devices or Equivalent C Attach additional detail if desired or as required by the Inspector of Wires. V \ Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: q. "Z 3 /7 eons 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. ........k) CHECK ONE: INSURANCE Pi BOND 0 OTHER 0 (Specify:) I certzfy, under the pains and penalties ofperjury,that the information on this application is true and complete, FIRM NA E: LIC.NO.: Licensee: Signature .3 2 (,,..\:....) (If applicable, nt � in t LIC.NO.. Address: /� ( a y+s�rrumb�r line) Bus.Tel.No.: f06 J *Per M.G.L. c. 147,s.57-61,securitylilwork requiresAlt.TeL No.: ep ent of Public Safety"S"License: Lic.No. — 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 CI owner's agent. Owner/Agent • I Signature Telephone No. I PERMIT FEE: $ I