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Home My WebLink AboutBLDE-20-002110 co Nu Commonwealth of Official Use Only te Massachusetts Permit No. BLDE-20-002110 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:10/16/2019 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 b Location(Street&Number) 87 QUARTERMASTER ROW �t0 CI-/. Lb(&.Q Owner or Tenant BURKE DONNA M Telephone No. Owner's Address BURKE CHRISTOPHER J, 3732 EDINBOROUGH DR, ROCHESTER HILLS, MI 48306 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. . Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement service. 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 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/Alertine Devices , No.of Dishwashers Space/Area Heating KW Local ❑ 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 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: Steven E Tullock Licensee: Steven E Tullock Signature LIC.NO.: 20114 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:4 RUTH ST, HARWICH MA 026451674 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:$75.00 qA_ to(o> c? ,‘e.so. (t(_.(c ) . (Q(Pz (;q ) J/1.4- odd (7 ._.._ 44 10/v46 4 k 62:asP44) Commonweal of Madaachueslta Official Use Only `'._ -.� Permit No. e u/--st _ :B,,•_. c� c� . :a;/1.. �[�sloar6nsnl o�,}ins�iroresd ``- BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked ` � [Rev. 1/07] (leave blank) 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: i a/ 16 PC• l °r' City or Town of: YARMOUTH To the Inspector of Tres: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) ' j'7 Ca,A�'Iz e `..t(,Sl c e Row S• A 2iJoo r h Owner or Tenant 4---0(-(,.., Ii7e"'r 24> Telephone No. Owner's Address J q 1-1 E- h this permit in conjunction with a building permit? Yes ❑ No IR (Check Appropriate Box) Purpose of Building 1` ES l 0€NTt A L Utility Authorization No. Existing Service tO C Amps / Volts Overhead a- Undgrd❑ No.of Meters New Service jo.2 Amps / Volts Overhead I Undgrd❑ No.of Meters k Number of Feeders and Ampadty 0/H c E t`] I C Ee IG-E_P IA C.£1-4 Fv /-- Location and Nature of Proposed Electrical Work: Completion of the following.table may be waived by the Inspector of Wires. Total 1.1, No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.ofKVA *, Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmin pool Above In- No.of Emergency Lighting g 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. Tons) No.of Alerting Devices Heat Pump Number" Tons _ KW No.of Self-Contained No.of Waste Disposers Totals: "" "'" Detection/Alerting_Devices No.of Dishwashers Space/Area Heating KW Local❑ !ate pti o1n ❑ other Connec No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring.• No.of Devices or Equivalent Kl i[OTHER: 1\ F- j z Attach additional detail if desired,or as required by the Inspector of Wires. ,L Estimated Value of Electrical Work: (When required by municipal policy.) ry,1 o i z I Work to Start: l d 1 p� �I9Irmspections to be requested in accordance with MEC Rule 10,and upon completion. — . N rNSURANCE C VE GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless I (-0 i the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The ± :J undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. 0 Ym, 7 CHECK ONE: INSURANCE gj BOND 0 OTHER 0 (Specify:) I.i vY,a ° certify,under the pains and penaldes of perjury,that the information on this application is true and complete. ce m IIRM NAME: 1 V &- T 11�K LIC.NO.: licensee: ��rV£ --V-4 kkOCJZ Signature�' j--.,+\ LIC.NO.: (If applicable,enter"exempt"in the is a number line.) 4'L6 Address: 2 5 v.). �1tem ov'�► t �- A/1-,y ovrry Alt.Bus.Tel.No Tel .• *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. � OWNER'S INSURANCE WAIVER: 1 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 Owner/Agent (check one)❑owner 0 owner's agent. Signature Telephone No. I PERMIT FEE:$ I