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Home My WebLink AboutBlde-20-001622 o. ORACommonwealth of Official Use Only E`.�►, Massachusetts Permit No. BLDE-20-001622 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:9/24/2019 City or Town of: YARMOUTH To the Inspector of Wires: �" f '2 By this application the undersigned gives notice of his or her intention to pertorm the electricalr`� work de b11 ed below. , tF�r "T J�W Location(Street&Number) 38 BLUEBERRY PATH VILLAGI �) LT[ ► Owner or Tenant FOX THOMAS W TRS(LIFE EST) Telephone No. Owner's Address FOX JEAN M TRS(LIFE EST), 38 BLUEBERRY PATH,YARMOUTH PORT, MA 02675 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: Replacement HVAC. 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 1 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 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: 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: $50.00 N17/4- cole/CP eg- fq)4, 1-ziCl(9 Ce___ Commonwealth o/l,/aasachusslts Official Use Oply, �� 2)eparfinenf o f.,emirs Serviced Permit No. �✓ BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rcv. 1/07] (leave blank) APPLICATION FOR-PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: q- 2 City or Town of: YARMOUTH To the Inspector of Wires: By this application the prtdersigned gives otice f his or her intention to perform the eleclri work described below. Location(Street&Number) (� [3(U.L Ee 17 PA tk YA r niot,c6t per{. Owner or Tenant j% t to b 1 Telephone No.a$-( (,(' 5' ' Owner's Address Is this permit in conjunction with a bra'ding permit? Yes ❑ No ® (Check Appropriate PP Priate Box) Purpose of Building ik 5i dgg1 f r Q Utility Authorization No. Existing Service Amps / Volts Overhead ❑. Und grd❑ No.of Meters - New Service Amps / Volts Overhead❑ Und grd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 11 v4c 0,1,02,74 Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Lnnunaires No.of Cet7.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Abov arnd. ❑ Be ❑ In- No.of l mergency Lighting erred. units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas Burners 'No.of Detection and Initiating_Devices bRanges No.of Total tJNo.of Air Cored Tons No.of Alerting Devices --7- No.of Waste Disposers Heat Pump I Number !Tons I KW No.of Self-Contained 3 Totals: Detection/Alerting_Devices No.of Dishwashers I Space/Area Heating KW' Local❑C Monnectionunicipal ❑ Other - d') No.of Dryers Heating Appliances , Security Systems:* No.of Water No.ofNo.of Devices or Equivalent KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent - `I No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: 4 OTHER: No.of Devices or Equivalent Attach additional detail f desired or as required by the Inspector of Wires. Estimated Value f Electrical Work: (When required by municipal policy.) Work to Start: Qi -/7 - ( eons to be requested in accordance with MEC Rule l0,and upon completion. d INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless i�, the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such copv rage is in force,and has exhibited proof of same to the permit issuing office. V CHECK ONE: INSURANCE I, 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: Licensee: D - LIC.NO.: (If applicable rarer.' r• Sign LIC.NO.• S` Z Address: € inthglic-+e mb�rffne.) }� ,�� S l� '(o �t k A-4 t p_w_ ,L4i c'7.4(c1 Bus.Tel No.: Wit _j "Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safe Alt TeL No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n ally Q 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 Telephone No. PERMIT FEE: $