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Home My WebLink AboutBLDE-20-000063 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-000063 _` 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:7/5/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electncal work described below. Location(Street&Number) 37 RAILROAD AVE Owner or Tenant CARLSON DONALD E Telephone No. Owner's Address 240 HIGH ROAD, KENSINGTON, CT 06037 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 ❑ 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: Wiring for mini-split system. 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 Initiating Devices No.of Ranges No.of Air Cond. 1 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: KUNG-PO TANG Licensee: Kung-Po Tang Signature LIC.NO.: 52286 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:518 COTUIT RD, MASHPEE MA 026492351 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: $50.00 Veoliq i .. 3 cm+nonvieatrh of mn44.,c Jeffs Official Use Only I■ ,� � c7� Permit No. N/ a� atpar ment of.y'ire Jartvicett'' =<<•' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank) APPLICATION performednaccordance FOR:PERMIT �O PERFORM Massachusetts Electrical ELECTRICAL WORK All work to be U (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: — - City or Town of: YARMOUTH 3 (� ' -,_.--.__.. .• To the Inspector of Tres: By this application the undersigned gives notice o his or h intention to perform the electrical work described below. Location(Street&Nu b ) —j 7 (LG�t I f'Oi,.d A t L/' Owner or Tenant L'Uc-v Telephone No.:c - nZ_9 76? Owner's Address Is this permit in conju ctioa Tith a ui1 ' g permit? Yes ❑ No Purpose of Buildings�` M c- (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead ❑. Und d t'r ❑ No.of Meters New Service Amps / Volts Overhead❑ Undg rd E No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the following table may be waived by the Irssvector of Wires. No.of Recessed Luminaires No.of Cer1.-Susp.(Paddle)Fans No.of Total Transformers ICVA _ No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming pool Above ❑ In- No,of L mergeacy Lighting grad. mud. 0 Battery Units No.of Receptacle Outlets No.of Ott Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and . No.of Ranges Na of Air Cond. / Total / �- Initiating Devices ( Tons i S No.of Alerting Devices No.of Waste Disposers Heat PPp I Number J Tons I KW •No.of Self-Contained Totals: I 1 Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' l; Local D Municipal Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equiva No.of Water No.of lent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent ,°i No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired or as required by the Inspector of Wires. - Estimated Value Electrical Work (When required by municipal oli tv Work to Start: iPl P cY•) �� V Inspections to be requested in accordance with MEC Rule 10,and upon completion. �� INSURANCE COVERAG : Unless waived by the owner,no permite n) co - the licensee provides proof of liability insurance including"completed operation""cco�ge or its substantial equivalent. .work may issue[he s 1� 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 � I certify, under the pains and penalties o 0 (Specify:) P f perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Signatur (If applicable, "ex t"'n the leer 3 LIC.NO.: /�i� — . Address: ,s t -�,a, fi r`rynbe fins.) � S `-1 l�n e `iq2' Bus.Tel.No.Alt.Tel. : 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 normally required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner 0 owner's a ent. t Owner/Agent Signature Telephone No. PERMIT FEE: $