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Home My WebLink AboutBLDE-19-003779 4?,oCommonwealth of Official Use Only Permit No. BLDE-19-003779 Massachusetts `«� 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:12/24/2018 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 o �J Location(Street&Number) 51 BRADFORD RD / " 51 V`-' '79l2 Owner or Tenant MILLS JEANNETTE AMATO Telephone No. Owner's Address 4,20 MONADNOCK RD,ARLINGTON, MA 02174-8001 Is this permit in cot�` a building permit? Yes 0 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 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. 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 ❑ 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 Siens 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: 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 � C J j1,2skle C�orrunoruucattfs of a,sachxsat Ot�nCiB se On _- � � �� - __-jo,_ _ 2cparfmrnt olI }ire Jousted =fit-= Permit No. -1.1=• ' Occupancy and Fee Checked =-:,,, ,�. BOARD OF FIRE PREVENTION REGULATIONS {Rev. 1/07] ' (leave blank) O .iO4" APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK I i i All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 C 12.D0 VVVV c (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: /p2 02/ jr l/" I t City or Town of: YARMOUTH To the Inspec or of Tres_ By this application the undersigned gives notice of his or intents n to perform the electrical work described below. Location (Street&Number) £/ ref, Owner or Tenant c y je 1 i1 I N S Telephone Na <PO l&-- Owner's Address ?if, Is this permit in conjuncts n witho yuilding permit? Yes ❑ No ! 1 ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service/OO Amps`)p Qyd Volts Overhead Undgrd❑ No.of Meters New Service Amps / Volts Overhead Undgrd ❑ No. of Meters Number of Feeders and Ampacity j r vt-g _, Location ,2 e " and Nature f Proposed Electrical Work: `` V�i P-e—�2,� ��G�lrt 'f/l it/�iia ee . s- N.-SP,.IN(cP-SZ�+ C. . , ' (\, Completionf the following table may be waived by die Inspector of If:es. ( J No.of Recessed Luminaires No.of Ceal.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.tor Hot Tubs Generators KVA No.of Luminaires S�itnmiag Pool Above ❑ In- ❑ ZVO.of Imergency Lighting _rnd. arnd. !Battery units No,of Receptacle Outlets No.of Oil Burners IFIRE ALARMS fNo.of Zones , --- -No.of Switches No.of Gas Burners No.of Detection and -' . Initiatate Devices No.of Ranges No. Total No.of Alerting of Air Cond. Tonsd Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained I I_ Detection/AIertine Devices _ Totals:1 Z. No.of Dishwashers Municipal Space/Area Heating KW Local ❑Connection OthF 31 No.of Dryers Heating Appliances , Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No. of No.of Data Wiring: 2 Signs Ballasts No.of Devices or Equivalent s No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring; - OTHER No.of Devices or Equivalent c� Estimated Value of El ctric Work O Attach additional detail if desired or as required by the Inspector of lyres. (When required by municipal policy.) it Work to Start: 9 Inspections to be requested in accordance with MEC Rule 10,and upon completion. biA INSURANCE C RAGE: 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 X BOND ❑ OTHER ❑ (Specify:) to cerizfy, under the pains and ennlries o a P f perj th the information on this application is true and complete.FIRM NAME: C5 ac:le JtSoiJS' C ♦ Licensee: s- LIC.NO.: ��a d I-J Signature LIC.N0.:1L��3 �l� (If applicable, enter"exemp�••in the license pu tuber link.) t ��v/L . Address: 37 43,`/t>J S i't'C Dr, €i Deli lr /°?a Bus.Tel.No.: .gStigfr j *Per M.G.L. c, 147, s.57-61'sectxr(ty work requires liepartment of Pu1Slic Safety"S"License: Alt Tel.No.: Lic.No. 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 ❑owner g tmally Owner/Agent El a Signature enL Telephone No. PERMIT FEE: $