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Home My WebLink AboutE-20-033 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-000033 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:7/2/2019 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 elec al work described below. Location(Street&Number) 112 ROUTE 6A �' tot Owner or Tenant iblitI'S PA Telephone No. Owner's Address , 112 ROUTE 6A,YARMOUTH PORT, MA 02675 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: Install sub panel&2 mini splits 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. 2 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 ❑ 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: Robert W Pierce Licensee: Robert W Pierce Signature LIC.NO.: 12359 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 FOSTER RD, E SANDWICH MA 025371040 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 CO 1/3(ry It ., _ ,..;::uwonwsaltta o ae6achaasita I Official Use Only lit - Apartment /cam_ n Permit No. �� 00 33 of.�5ris J \ 1 lj I Occupancy and Fee Checked V" QU' BOARD OF FIRE PREVEN1TION REGULATIONS ev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),52 CMR 12.00 'PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: i /z � l 1 City or Town of itoc,i alvv fit MI" To the Inspe for o ires: -By this application the undersigned gives notice o('his or her intention to perform the electrical work described below. '; i�a�� Location(Street&Number) U U L V4,6:1,tA c f, "V A) Y Owner or Tenant Telephone No(96%i3OO-to jcd Owner's Address Stetvic, ' \L�— fstljs permit in conjunction with a building permit? Yes El No (Check Appropriate Box) V--, Purpose of Building teA I4A..4A ue- ! Utili Authorization No. $xisfing Service Vle Amps t2-4'/2 Y0 Volts Overhead Undgrd❑ No.of Meters _.�m,_.m__,.'.. __. Volts Overhead Yee w Service Amps / ❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity i Location and Nature of Proposed Electrical Work: k_ S,i, e .4 t' 7_ x -ittit d i(tLf `/ S Completion of the followin table may be waived by the Inspector of Wires. 33 No.of Total UINo.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting �. Rrnd. grad. Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 'No.of Detection and CSm No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Toonnsl No.of Alerting Devices J No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 1 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Monneunicctipalion 0 Other C No.of Dryers Heating Appliances KW Security Systems:* J No.of Devices or Equivalent J No.of Water KW No.of No.of Data Wiring: L c Heaters Sigjs Ballasts No.of Devices or Equivalent Telecommunications Wiring J No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: .4ttach additional detail if desired or as required by the Inspector of Wires. V Estimated Value El 'cal Work: i 7i°41$ ! (When required by municipal policy.) 'i-' Work to Start:6 L' Ins ons to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE 0 GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless i✓ the licensee provides proof of liability insurance inirluding"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of pedury,Ithat the information on this application is Due and complete FIRM NAME: lazdz 1:7igrGR 4.1PLhr-tc.to LIC.NO.: i23$' -B Licensee: 6{p le('CrQ� Signature � 54 �4✓ . LIC.NO.: Me. (if applicable,enter"exempt"in the lice a number line.) (/ �''"' (/ Bus.TeL No.: 2zZ.3R$ Address: !2 Fos f k a, i..S IA MA Z JY31- Alt.TeL No.: $ —ZY el *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 Owner/ by Agent law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner''agent. Signature i Telephone No. I PERMIT FEE:$