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Home My WebLink AboutBlde-19-006409 Commonwealth of Official Use Only of Permit No. BLDE-19-006409 Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:5/13/2019 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 electrical work described below. Location(Street&Number) 182 OLD TOWNHOUSE RD N (O k-Atil 4 ( Owner or Tenant ANDERSON KENNETH A Telephone No. Owner's Address C/O JOHN MCMULLEN, 186 SHEEP POND CIR, BREWSTER, MA 02631 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: Upgrade lighting. (UNIT B) 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 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Imtiatine 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 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 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: Paul M Morris Licensee: Paul M Morris Signature LIC.NO.: 17520 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 213,1 COUNTRY WAY,SAGAMORE MA 025610213 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: $80.00 C • "' Cotnmonweat k of 7fiassacluedatts Utticlal Use Only , cl— (409 ' , '� cc77� Permit No_ 6 ;fit 2epartment o/...fire Services 1'�. �' Occupancy and Fee Checked '':r,`�/,° BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PE 7'MfT TO PERFORM ELEC`r DGAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: j r ' /67 City or Town of: A-tl/l.�u� . To the Inspector df WI es: By this application the undersigned 'ves notice of his or her intention to perform the elec cal work descrihedibelowil Location(Street&Nmber) I 1 7, o ' I p-•�i �, {\., i -- Owner or Tenant 1 l 1D k Pr I..4 AkQ dk 1r-F7 i--- Telephone No. D 3 i- 8' Owner's Address 5 " ' I 1 (o Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd D No.of Meters ,New Service Amps / Volts Overhead❑ Undgrd b ❑ No.of Meters Number of Feeders and Ampacity _ Location and Naturej (�of Proposed Electr' Work: I Q--( ' '` tw, ' 3) Completion ofthe.followingtable 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 Ag i owe ❑ In- ❑ No.of Emergency Lighting mod• grnd. Bad 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. TonsTol No.of Alerting Devices No.of Waste Disposers 'Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal P Local❑ Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Ballasts Signs Ballasts of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring No.of Devices or Equivalent OTHER: ' Attach additional.detail([desired,or as required by the Inspector of Wires Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: � inspections t'tequested in accordance with MEC Rule 10,and upon completion. INSURANCE COVTRAGE: 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 ❑ (Specify:) • I certify,under e pains and penalties ofperjwy,that the information on this application is true and complete. FIRM NAME: '{�1 In �-�P Chin' L (JZN L _ LIC.NO.: Licensee: ( l p2e.aS l Signature/ jl.," LIC.NO.: I'i6ZJ/�' (!f'applica t err 'exempt"in the l' ense number line,) Bus.TeL No.:�aD? --/1 b `1 L4 y Address: 0 laa' -. 1012 S-t ill° p A- Q,L G 6 1 Alt Tel.No.:,TD 1, ' DI) 01,39 *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 normally required by law. By my signature below,I hereby waive this requirement. I am the(check onel❑owner ❑owner's agent. Owner/Agent �y Signature . Telephone No. E IT FEE: b , t p. � k 'Mtrc�-1��t ti �. u , ii1e--n