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Home My WebLink AboutBld-19-006981 Commonwealth of Official Use Only to Massachusetts Permit No. BLDE-19-006981 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 electncat work described below. Location(Street&Number) 15 CROMWELL DR Owner or Tenant GYSS GARY J Telephone No. Owner's Address GYSS JANET G, 32 FRANKLIN ST, RAMSEY, NJ 07446 Is this permit in conjunction with 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 A/C condenser. 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 0 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. 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 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: 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 ^�e f, Commonwealth of///amac tti Official Use Only in i ��== apartmant oi5i. Serviced Permit No. —_ ,- . BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked rRev. 1/07) (leave blank) kr 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: City or Town of: YARMOUTH To the Inspector of Wires: gy this application the 'undersignedgives notice of his or her intention t dorm the ele 'cal work described below. * " z Location(Street&Number) Grd- (AI okr Oner or Tenant �`t,.R''� _ SS / Telephone No. Owner's Address / 4— �( ix_-;may-{ ' Is this permit in conjunction th a •` ''t.in permit? Yes ❑ No 4i4ti ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No, �J r � Existing Service/i 1 Amps Ael ptib Volts Overhead Undgrd❑ No.of Meters ,.? New Service Amps / Volts Overhead Undgrd ❑ No.of Meters Namber of Feeders and Ampacity CA) / ILL, A-C_- ....\4-i k 1 dfi-yilx-c A$72 Location and Nature of Proposed Electrical Work: Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ce2-Busy.(Paddle)Fags No.of Total Transformers HyA No. of Luminaire Outlets No.of Hot Tubs Generators ICVA No.of Luminaires Swimmia pool Above In- No.o1 Emergency Lighting - g rrnd. arnd. Li Battery Units No.of Receptacle Outlets No.of Ott Burners FIRE ALARMS INC.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump!Number I Tons I KW No,of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KWLocal❑ Municipal Connection ❑ Other _ No.of Dryers Heating Appliances KW Security Systems:* t No.of Water No.of Devices or Equivalent Heaters ' - No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - OTHER: No.of Devices or Equivalent O.., �_ 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: Inspections 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 the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. Thess undersigned certifies that such coy ge is in force,and has exhibited proof of same to the permit issuing office. 4, CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. 1. b FIRM NAME: �5�d f � �rie Licensee: " e-- LIC.NO.: e l_ !: Signature �/ (If applicable,enter"es pt"in t e license number line.) €- LIC.NO.:��/ Address: Bus.Tl.No.: /�/ J `Per M.G.L. C. 147,S.57-61,security work requires Department of Public SafetyAlt.Tel.No.: j� — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance overage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner ❑owner's a:ent. Owner/Agent alSignature Signature No. . PERMIT FEE: $ r