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Home My WebLink AboutBld-20-001521 Commonwealth of Official Use Only at. I - Massachusetts Permit No. BLDE-20-001521 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:9/17/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pe i the electrical work described below. Location(Street&Number) 23 DAUPHINE DRl-ne (�ANI0 (,(� �, Owner or Tenant J . D J Telephone No. Owner's Address —.1;4111116/41920,YARMOUTH PORT, MA 02675-0623 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install generator 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 1 KVA 11 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 1 No.of Gas Burners No.of Detection and Initiatine 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 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: SEAN C ROGAN Licensee: Sean C Rogan Signature LIC.NO.: 20141 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 MELIX AVE, PLYMOUTH MA 023601280 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 0 owner's agent. Owner/Agent Signature \ Telephone No. I PERMIT FEE: $50.00 I Di°--C-C) Id 25ICI' e Commonwealth of iita33ach•.miffs Official Use Only '• ��— �� t i= -, -naparfneRE o f.�i,�...�arvi� - BOARD OF FIRE PREVENTION REGULATIONS Occupancy 1/07] and Fee Checked (11. �. •''• [Rev. I/07] cleave blank) ' APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK -� All work to be performed in accordance with the Massachusetts Electrical Code '... U (� (MEC),527 CMR]2.�0 (PLEASE PRINT IN INK OR TYPE ALL INFOR&L4TION) Date: 9// 7//j City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) 23 dAvehi It L)rly& Owner or Tenant 6o, ,e r / /0c. Telephone No. Owner's Address S43fry Is this permit in conjunction with a building permit? Yes ❑ No Q----- (Check Appropriate Box) Purpose of Building L)L✓l//15 Utility Authorization No. Existing Service Amps J / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /// y (C/ie ); r -/- /6 Ct' -viz' s-e,0-t 1 /-) Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cet1.-Susp.(Paddle)Fans No.of Total Transformers KVA _ No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No.of It mergency Lighting und. ❑ arnd. ❑ 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. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump[Number I Tons I KW No.of Self-Contained Totals:I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local D Municipal I- Connection Wier No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP No. 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.) s Work to Start: `7//4Z//-, 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 unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The c, - undersigned certifies that such cove is in force,and has exhibited proof of same to the permit issuing office. c1 CHECK ONE: INSURANCE [i]-BO ND 0 OTHER I cemfy, under the pains andpenalties o0 (Specify:) f perju fury,that the information on this application is true and complete. 1 FIRM NAME: SC i /-`/e. vc 1,C LIC.NO.:42i4I Licensee: S'r.z.t G /g6omv Signature LIC. o.: '? 111 (If applicable,enter"rsempt••in th license[cumber line.) . Address: 2_7 /'Mis r' ,- /'/i M, Bus.TeL No.: r j "Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.)sic.No.� — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage norin S required by law. By my signature below,I hereby waive this requirement I am the(check one ❑owner o Owner/Agent ❑owner's a ent Signature I Telephone No. PERMIT FEE: $ 3 0