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Home My WebLink AboutE-20-646 ti9\1 Commonwealth of Official Use Only E. t. • Massachusetts Permit No. BLDE-20-000646 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:8/5/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 32 GORDON LN Owner or Tenant MELO CASSIO R Telephone No. Owner's Address 32 GORDON LN,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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: Bonding&wiring of pool. 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. 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 ❑ 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: BRIAN A SMITH Licensee: Brian A Smith Signature LIC.NO.: 24307 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:20 GELDING CIR, BARNSTABLE MA 026301503 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:$135.00 r /� _ - Commonwealth of///assaeffs Offs ' Use Only ':Si', - 1J oarfinr ol.yin Serviced .'.. '` ..'i Permit No. 01+ -�- 1 �J BOARD OF FIRE PREVENTION REGULATIONS e . uo ] and Fee Checked fRv 1/07 (leave blank) r- --Z APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 �F, I w Lj PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: —'I r_ I a City or Town of: YARMOUTH To the Inspector of Wires: l w y this application the tndersigned gives notice of his or her intention to perform the electrical work described below. LU ,� a cation (Street&Number) , ( eI1O c/ z• V � a Z Jp/�/ ,o ner or Tenant (c� 5j/) /� Telephone No. i U i - J wner's Address 3Mjp/f : rem s this permit in conjunction with a building permit? Yes Er No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service ,j'l) Amps /do /..7yo Volts Overhead Le Undgrd❑ No.of Meters f New Service Amps / Volts Overhead Und rd e) ❑ l; ❑ No,of Meters p Number of Feeders and Ampacity c. Location and Nature of Proposed Electrical Work: / Jy4/,f4 zi is tJ/ / ( may}_. / ' Completion of the following table may be waived by the Inspector of Woes. 44. No.of Recessed Luminaires No.of CeiL-Snsp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs G nerators KVA - No.of Luminaires Swimming Pool Above ❑ In- LrJ .of Emergency Lighting sand. Qrnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1N• o.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatins;Devices No.of Ranges No.of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump I Number l Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Loth❑ Municipal Connection ❑ Othr No.of Dryers Heating Appliances , Security Systems:* No.of Water No.of No.of Devices or Equivalent \D Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs Wiring: y g No.of Motors Total HP Tel No.of Devices orEquivalent OTHER: _ Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work (When required In quired by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. t 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 [BOND 0 OTHER 0 (Specify:) I certify, under the p ns and pena�s of perjury,,that the information on th' pplic • is true and complete. oi FIRM NAME: 0,e 9A/ ✓47/77/ LIC.NO.: ‘' Licensee: .�, pize Signature (If applicable,enter/ empt"in the license numbe line.)/ C.NO.: Address: �Q �FL,4JN C/ A e T IC Bus.Tel.No.:SDSi 9 9 Alt.Tel.No.• ,j "Per M.G.L. c. 147,s.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 n— o — S required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner Owner/Agent ❑owner's a enL Signature Telephone No. PERMIT FEE: $ f'js-�