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Home My WebLink AboutBlde-19-000686 • or tgt Commonwealth of Official Use Only fE _ Massachusetts Permit No. BLDE-19-000686 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:8/3/2018 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) 16 GUN ROCK RD Owner or Tenant CHRISTOPHER ROBERT J Telephone No. Owner's Address CHRISTOPHER MARGARET M,309 RIDGEPOINT PL,GAITHERSBURG, MD 2087: Is this permit in conjunction with a building permit? Yes 0 No 0 (Chec • .1 . ' e Box) cp Purpose of Building Utility Authorization No /� Existing Service Amps Volts Overhead 0 Undgrd 0 ` w New Service Amps Volts Overhead 0 Undgrd . ere li f//zamte Number of Feeders and Ampacityn f Location and Nature of Proposed Electrical Work: Split A/C&boiler replacement. Completion of the following table may be waived !� of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of :1 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 Imtiatine 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/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 Sins 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: Bryant K Dundon Licensee: Bryant K Dundon Signature LIC.NO.: 53109 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:67 TAURUS DR, MASHPEE MA 026493458 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 (6/2yke qt, c(a.IC l ‘.. R ' " .) 0,Y -�_ Co / mrnonwaalg of/,/y�assackusslts Official Use Only rcf/lA .: + >d -t cc�� c77 / _ O r{ = 2a artmanE f.t' s Permit No. 6�� . p o cra arvicss c= • Occupancy and Fee Checked >••• BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/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: a — f (' 10 City or Town of: YARMOUTH To the Inspector of Wires: v) By this application the undersigned gives notice of his or her intention to pgrform the electrical work described below. "7 Location(Street&Number) C. Z Owner or Tenant 5, / c.,,,-c Telephone No. P �r✓SS - Z3 7-Z(s. ,Owner's Address /C. �j— Gr i Pc/ ` Is this permit in conjunction with a building permit? Yes No / ❑ 0/(Check Appropriate Box) \ Purpose of Building /c> �.-p__.- Utility Authorization No. Existing Service Amps / Volts Overhead D. Undgrd El No.of Meters ._ New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters `�U Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 4, -te 7 Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceii.-Snsp.(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. trod. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating DevicesTotal _ 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/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection � Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of Heaters KWNo.of Data Wiring; 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 desirec4 or as required by the Inspector of Wires. Estimated Value of Electrical Work: /000r a d (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COV RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability in ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such covera s in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:) I certify, under the pains and penalties of pe ' that the information on this application is true and complete. FIRM NAME- vJ-- LIC.NO.: Licensee: F- �r/c Si afore �3(G 7 (fapp • 2_ > LIC.NO.: _ c_.applicable,enter"exem the license number line.) Address �� Bus.Tel.No.: c.---, �fl /��Sd.24s,C �-. 1/ GI Alt.Tel.No.: G J *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic. No. lG�� -- 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)0 owner ❑owner's agent. 1 Owner/Agent j Signature Telephone No. I PERMIT FEE: $ 1