The URL can be used to link to this page

Home My WebLink AboutBlde-19-006987 Commonwealth of Official Use Only / E Massachusetts Permit No. BLDE-19-006987 `� 1; 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:6/11/2019 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) 329 ROUTE 6A Owner or Tenant FIRST CONGREG CHURCH OF YARMTH Telephone N 1 Q Owner's Address ROUTE 6A,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 I 01 Itl 1 p . ) Purpose of Building Utility Authorization No. i 0 .r Existing Service Amps Volts Overhead 0 Undgrd ❑ e • s�� New Service Amps Volts Overhead 0 Undgrd 0 "1.s s rr, Number of Feeders and Ampacity ...' Location and Nature of Proposed Electrical Work: Upgrade lighting. Completionthefollowing o/� follo rig table may be waive , Spector 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/Alertine 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: Paul M Morris Licensee: Paul M Morris Signature LIC.NO.: 17520 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 213,1 COUNTRY WAY,SAGAMORE MA 025610213 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:$80.00 �= Lotnrnonwea. z of{�,/7.4ar�xccoat' Official Use Only 1` t r c� c7 Permit No. ��.-(QI67 S- 2epartment o10.. ire Sertricas Occupancy and Fee Checked '„ �° BOARD OF FIRE PREVENTION REGULATIONS [Rev_ 1/07] (leave blank) AP0 LOCr`,THON FO ill\ PERMIT TO PERFORM ELECTRICAL ®ILK :. All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 17_00 (PLEASE PRINT IN INK OR TYPE ALL INFORIIL4TION) Date: (4/1 / g City or Town of: f-(l�� J�t To the Inspector o Wires: By this application the undersign gives notice of his or her intention to perform the electrical work described below. Location(Street&N _ ber) ,,5 - ' rn Owner or Tenant - h-�s r Ck t.A Telephone No. 51) Q 3 l Owner's Address 1 I �. • conjunction with a buildingX., G 5 7 '") Is this permit in permit? Yes ❑ Na ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead New Service ❑ Undgrd 0 No.of Meters Amps / Volts Overhead 3r 0 Undgrd❑ No.of MetersNumber of Feeders and Ampacit Location and Nature of Proposed Electrical i7t/ork. • t �1 ^ 1 Cont•!coon ofthe/olloiwin, tablet may be natit ed by the Inspector of Wires- No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans `o.o Kotal VA No,or Luininaire Outlets N Transformers o.of Hot Tubs Generators KVA No.of Luminaires Above In- swimming Pool • a . ❑ !rnd. ❑ 10. o •Yn its • .' y Lig t r i g N .of Receptacle Outlets Bate Units . No.of Oil Burners 1FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners I o.of Detection.and No.of Ranges Initiatin_ Devices No.of Air Cond. otar No.of Waste Disposers Tons No.of Alerting Devices 'eat Pump Number oris s3 Totals: No.ofSelf-Contained No.of Dishwashers DetectioNAlertina Devices Space/Area Heating KW (Local 0 Munlclpa No.of Dryers __ Connection ❑ Other i Heating Appliances t ecun stems: To.o "ater — o,of .. No.of E evices or E uivalent Heaters KW o.of 4 IData Wiring No. Fiydromassage Bathtubs Si ns Ballasts No.of Devices or E.uivalent No.of Motors Total HP elecommuniartions Wiring: OTHER: No.of Devices or E.uivalent Attach additional detail ifdesiretl.or as,equiredbi,the Inspector ofWires. Estimated Value of Electrical Work: Work to Start (When required by municipal policy.) d in INSURANCE COVERAGE: Unes Inspections y d b ownerr,no permit force with IvIEC th performancele 10,and of electrical upon completion. he licensee provides proof of liability insurance"including"completed operation"coverage or its substantial equivalent indersigned certifies that such coverage is in force,and has exhibitedproof of same to the 1 work may issue unless :HECK ONE: INSURANCE q lent. The BOND ❑ OTHERpermit issuing office. certify,rrrrder, re 0 (Specify:) pains and allies ofperftny, f !1hu1a1 on this application is tare and complete. rape icert.s�e _1 1� T 1 t)(2.,Q.L Sil afore ,� � LJC.NO.: r rug arenrpt' in the r'ertse ntattberline) l LIC.NO.: j JSZc�{�. ddress: Q "L1j v.; j y i=r►'1')G?e . OZS Bus.TeL No.:SDK -71 b �l(,wry 'er M.G.L.c. 147,s.57-61,security Work requires Department of Public Safe '`S"License: Alt.Lic.No. Tel.No.: �-7! y o0 01�3� WNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coveran normally luired by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. �vner/Agent ;nature Telephone No. &' w P PERMIT FEE:S t�D t�1 'M fyn e-t c}r-e i ` 0_ D-e @..\ , if\e-