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Home My WebLink AboutE-20-1062 . or Massachusetts Commonwealth of Official Use Only Permit No. BLDE-20-001062 k�E 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:8/26/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to orm the eleeti4c.W work described below. Location(Street&Number) 9 SACHEM PATH K` ( SM Owner or Tenant .-:_ :.:<_ =. '- Telephon• No. Owner's Address -- 11) Is this permit in conjunction with a building permit? Yes 0 No 0 C Box) Purpose of Building Utility Author' tion No C 'i t Existing Service 100 Amps Volts Overhead 0 Un grd 0 -NO.ofMeters / e V/941 New Service 200 Amps Volts Overhead 0 U dgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Relocate&upgrade service. Completion of the following table maybe 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- ElNo.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 ❑ 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:) C ^� z o� I certify,under the pains and penalties of perjury,that the information on this application is true and complete. .) l (P FIRM NAME: Licensee: Bryan V Hall Signature LIC.NO.: 55546 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:7 Plantaion Road, Mansfield Ma 02048 Alt.Tel.No.: 5085622906 *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: $75.00 14 t...ommonwsaR al , aamelutasllo Official Use Only v. sr ccryry� {{�� Permit No. r t`-4' v V ) ' ? .Llrf�arratnenf ot i,+s 7src�icsa ." BOARD OF FIRE PREVENTION REGULATIONS Re eup cy and Fee Checked .6,.+« (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK r� All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 7 CMR 12.00 • (PLEASE PRINT IN INK OR TYPE ALL INF RM.ATION) Date: gj /� 9 0 City or Town of: yAm-Do}1 To the Inspector of Wires: q By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Of 5o hejn VAT H J Owner or Tenant R 105 Ten$tl4\ r Telephone No. q)c� -111'l 72 CO Owner's Address q 5,6w...t`it Po.�-IN Is this permit in conjunction with a building pe it? Yes ❑ No Ki (Check Ap ropriate Box)/ Purpose of Building ./�(✓i<,e O`1 Utility Authorization No. 3c �S b J Existing Service IQ) Amps P.O / )'1O Volts Overhead 50 Undgrd❑ No.of Meters 1 1 New Service 2.043 Amps ()0 440 Volts Overhead IX Undgrd 0 No.of Meters 1 t„; Number of Feeders and Ampacity ` —0! Location and Nature of Proposed EIectrical Work: $'CV i( k --LD C,fty n W 0-p5f'de- Completion of the following_table may be waived by the Inspector of Wires. °" No.of Total No.of Recessed Luminaires No.of Ceti.-Susp.(Paddle)Fans Transformers KVA AZ) No.of Luminaire Outlets No.of Hot Tubs Generators KVA rY. 4 No.of Luminaires Swimming Peal `above ❑ In- No.of Emergency Lighting g grad. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones ` � h. No.of Detection and No.of Switches No.of Gas Burners Initiating Devices i No.of Ranges No.of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump Nnmiier, Tons KW 'No.of Self-Contained Totals: Detection/Alertin Devices Wiry Dishwashers Space/Area Heating KW Local❑ Municipal ❑ (rhea i Connection ® SecuritySystems:* \ N.a"Dryers Healing Appliances I WV No. f Devices or Equivalent ' 0:' S. 1 Water KW No.of No.of Data Wiring: �'o Heaters Ballasts - J ! cs Signs No.of Devices or Equivalent N�. ydrnmassage Bathtubs No.of Motors Total HP Telecommunications Wrningg LIJ c\t No.of Devices or Equivalent o OTHER: R: 111 p�5 .p 7 Attach additional detail if desired,or as required by the Inspector of Wires. -cc _ Value of Elec ical Work: ?/Opp (When required by municipal policy.) aria Start: $/)71/" Inspections to be requested in accordance with MEC Rule 10,and upon completion. CE 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 t4 BOND 0 OTHER 0 (Specify:) I certiA,under the vii ns and penalties f perjury,that the1� information on this application is true and complete. FIRM NAME: ` nia } 1 Ie c+c 'r / LIC.NO.: S5S u 6 -a, Licensee: Signature___,, LIC.NO.: �n (If applicable,enter' nipt"tin(he license tuber line.) AA o Bus.Tel.No.•3Q8-5(Da�—�1O 6 Address: 7 pI6CItAt%D1 V f n,5tieta 1`fit o)v $ Alt.Tel.No.: *Per M.G.L.c. 14 , .57-61,security work requires Department of Public Safety"S"License: 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 ❑owner's agent. Owner/Agent 7 J Signature Telephone No. PERMIT FEE:$