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Home My WebLink AboutBlde-18-005460 (2) A/ Commonwealth of Official Use Only Iff.A Massachusetts Permit No. BLDE-18-005460 t•`""f BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked SRev.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:4/2/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice ol'his or her intention to perform the etectruafwork described below. Location(Street&Number) 62 PARK AVE Owner or Tenant ANDREWS EDITH E Telephone No. Owner's Address ANDREWS LEONARD A,62 PARK AVE,WEST YARMOUTH,MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Che k Appropriate Box) Purpose of Building Utility Authorization No4 Existing Service Amps Volts Overhead 0 Undgrd a of Meters Yew Service Amps Volts Overhead ❑ Undg lets Number of Feeders and Ampacity O , Location and Nature of Proposed Electrical Work: Replacement boiler = 19 • Completion of the following t• . ' nspector 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 0 In- 0 No.of Emergency Lights • grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners 1 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 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:" No.of Devices or Euuivalent No.of Water KW No.of No.of Data Wiring: ,'caters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total IIP Telecommunications Wiring: No.of Devices or Enuivalent OTHER: Attach additional detail ifdesired 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) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FE$11(ct E:S200.00 e"6 tf(, ($ (Sc� Trr2Ca�t�17 �-'L A 6 arnon-0rvr dg CI .c6.44 Oi�ncial^st x� _ ..`ireJerni.• dd �O +� �� .� Permit No. o. Oceapm y and Fee Checked j II -•,,_>� FIRE.(( ' BOARD OF RE PREVENTION REGULATIONS I/07] • nerve bleak) ~— • 6te APPLICATION FCR°P5RMIT TO PERFORM ELECTRICAL All work to be pert, in aoonrc nne wit the Massachusetts`*-loo cal Code(MEC),527 Cla l (PLEASEPRINTINItKOR IPEA�D1FOPJJ 4T101V) Date: / "� 0/1.7 City or Town of: yARMQU 1H t: ibis 5c ' To the I ache o Wtres. By app anon the uadersipied ves notice()ibis CC bar intend to _ f a?� Airc. the electrical descnb Location(Sheet&Number) A I --\ Owner nr Tenant r f• Tetcpitone s,✓G7S� Owner's Address - _ is this permit in coajrracrion with a built m.g permit? Yes ❑ No$ (Check Ap ro ) �• - Purpose of Bunning dr.J e,' II • P P �Box " �- A77tiOrI23ndn No. Ea�rg Service jot?) Amps �.,}t fl I Q O Yolk Over cad ❑ (,!i., Y Ua red No.of 1� L .. c ServiceAmps / Volts Ovcrhetd 0 Undgrd or 1 `~ :1- Newf Nuialts of Fedf s and- ❑ N .of Myers t` 4arp_crty (if) crc/ �o ,G� U. I Location and Nttere of Pr coos- M rfczl Work: .. • �P w [Ll _ No.of R:t � _ems C !man of the fo&r,v r=able iney Be wowed by the Ir.1p._eror o flp No,of CeiL-.Snip_(PaddL-)Ftn.of �1 f~ E.m I1rzIISfor er IL'VA�.._ No.of Ltraninatre Otrtie*s No.*of Hot Tabs G_aerztors • ]s'V,4 No.of Lsmia 5F4'iSsaig Pool aS�noz 0 m- ❑ {4f+n.DI Jsna gmc9 �: No.of R c^.-'prticSe OQ-Ts `'mod' I't,sY:�p Uaas . No.of OilB>r nets :ME ALAPM5 jNa.of Zones No,of 5 s No.of GasB�ers • iNo.of De oa en ,� No.of r"tan�� Total II =Devices Nos.of b it Cond. Tons No.of A.ixtin Devices No.of Wass:Disposers Heat Tamp I Number'Tons K LN a d of Self-Con{sta -�. b, Totalsx Detettortllilerun!Den= No.of DishwashersSgacdkres Hestia; KW Loral Q Mtmir�tiodvan ❑ 0��ba- 1 , • elCatm No.of Dryers Heading Appliances IOW ety Ysten:ts:` V Na,o Ater o,of Na.of Devices or Ecruivaleat �� Heaters KW No,oI Data Wing: t Sins Ballasts No,of Devices or • Bivalent No.Hydromassage Bathtubs No.of Motors Total FIP T mtneairitioas [11mb OTHER Na of Devices of L cleat • Estimated Valve of Electrical Wort: �,�-�Agach odditiona!dealt if detire4 or as required by the f f (When req ire by mpolicy.) for o�Firm 20 StartI�� Inspections to be reguermr d in accordance with MEC Rule 10,and upon completion. INSLIRANC'E COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless b 11 the licensee provides proof of liability insurance including'completed operation"coverage or its substantial undersigned cerdes that such coverage ism force,and bus exhibited proof of same to the permit issuing office. The CHECK ONE: INSURANCE Mr BOND 0 OTii. 0 (s J r crrsf',ts,zdtr the prams and. PITY) NAME: enalli�ofp r that the information on this apprt-ca:`iorr is true and compt ete- i FIRM - �eritis 4.64,'2�',42,- LIC.NO.: s" Licensee: Signature , 1fapplicoble.enter" "in the liec ue number lirme) ',�~c •e��`/ LIG N�"fs=ae-a�_ Address: Bus,TeL No j 'Per M.O.L.e, I47,s.57-61,security work regoires Department of Public Safety"S"License �!t No. OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have toe liability inssraQce eoveranzity required claw. By y signature below,I hereby waive this requirement I am the(cheek one 0 owner owner'sn eat_ • S14nature •S Telephone No. PERMIT FEE.