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Home My WebLink AboutE-20-777 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-000777 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:8/12/2019 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) 572 ROUTE 28 Owner or Tenant RICHARDS SUSAN J TRS Telephone No. Owner's Address RICHARDS PAUL K JR, P 0 BOX 90, ESSEX,MA 01929-0002 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: Wiring for sign lights. (J('( T 5 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- 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/Alerting 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 1 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $80.00 I CA 6 ,(t2( tti 4 Commonwealth.of MwsacLetts • Official Use Only � C777 aid- i 2epartmarit aI.�'7.fire Services Permit No. 1 =1�- '• ' Occupancy and Fee Checked __ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] Y' ��• (leave blank) 7) 10 ' • ( APPLICATION FOR PERMfT TO PERFORM ELECTRICALWORK All work to be performed in accordance with the Massachusetts Electrical Code \ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: (MEC sz7 t z.00 City or Town of: YAR1VIOUTH To the applicationrindersigned gives notice of his or her intention to perform the electrical Bye tor Wires: this the work described below. Location (Street&Number) Z er or Tenant 1S"d G�"')v f7t ,A-4Q cj(, ui \ er's Address Telephone No. +t,, .. I Q I this permit in conjunctionwith aa'�build' g permit? Yes ❑ No �� (Check Appropriate Box) —°w Ik o) j w P rpose of Building P �J'M po Utility Authorization No. 1' o °0E' 'sting Servicer damps / e' _ ,z �� Volts Overhead Undgrd❑ No.of Meters L!_ I o.¢ !J Service Amps / Volts Overhead 0 Undgrd Meters 11 )2 ''.�1 m i, ber of Feeders and Ampacity lid �_ Peal > /of/ ,__.._ -......,-- _ ation and Nature of Proposed Electrical Work: / �L�( /� Completion of the follcrwing table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceti.-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 - Vsad grnd. Battery Units No.of Receptacle Outlets No.of Ott Burners FIRE ALARMS 1No.of Zones ''Np 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 I Number I Tons I KW No.of Self-Contained ' Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ er `2 No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent V Heaters ' No,of Data Wiring: Sighs 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 lec cal Wor)v �� (When required by municipal policy.) N. Work to Start:g Inspections to be requested in accordance with MEC Rule l0,and upon completion. O INSURANCE C GE: Unless waived by the owner,no permit for the performance of electrical the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. -mess 4 undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. O Q. CHECK ONE: INSURANCE X BOND 0 OTHER 0 (Specify:) ix I certify, under the pains and penalties of perjury,that the information on this application is true and complete .A FIRM NAME: Q `¢-Sapis 0/e—et't:4c--- LIC.NO.: , s.2 re? Licensee: -/j, S rAr Signature .�G _'-� // (If applicable enter" t"i�t license number l' e.) LIC.NO.' Address: 37 ////�,/ry.rr,'7��I ie � �f i 7q Bus.TeL No.: Tel. j Per M.G.L. c. 147, s.57-61,sec y rk requires Department of Public Safety'S"License: Alt.Lic.No.. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n— ormallyy S required by law. By my signature below,I hereby waive this requirement. 1 am the(check one)0 owner ❑owner's vent. Owner/Agent l Signature Telephone No. I PERMIT FEE: $ (