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Home My WebLink AboutBLDE-19-006974 d Commonwealth of Official Use Only kin- Massachusetts Permit No. BLDE-19-006974 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:6/11/2019 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 electoic41 work� described below. Location(Street&Number) 127 BREEZY POINT RD Utk, lri(___Owner or Tenant MOQUIN RAYMOND P JR TRS Telephone No. Owner's Address MOQUIN BEVERLY A,7 QUEENS TER, HOLLISTON, MA 01746-1114 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 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade 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 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/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 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: William C Fligg Licensee: William C Fligg Signature LIC.NO.: 12584 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:55 FREEMAN RD,YARMOUTH PORT MA 026752304 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 * Commoauisa of machlfs ,. -• Official Use Only i= c� c-7� Permit No. C( -(Q q4 =:/! .2lcpartmcnt o/.}irs Servicss BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked {Rev. 1/07] ----(leave blank) 1 APPLICATION FOR-PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical?ode(MEC),5 CMR 12 00 (IEL SE PRINT IN INK OR TYPE ALL INFORMATION) Date: Le— q w �• �I W- City or Town of: YARMOUTH To the Inspector o Wires: cm i�,�� 's application the undersigned ' es n • ' of his or her int-.... to perf rm a ectri G lcal y de cubed below iW 'on(Street&Number) I -) 1 h r or Tenant �.�lt�vtt V,,� (� �- Telephone No. Ll.i�o i _ is Address permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) cc se of Building Utility Authorization No. r'xzstung Service IC)`) Amps t,F lt 7j/ Z`e--tos Overhead E"-----Und d gr ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd>n E No.of Meters Number of Feeders and Ampacity Location an Nature Proposed Work: (L,el � C,a( 1 �L�cJ lQR 4�Q �:1 �1� �S 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 I✓mergency Lighting - =rn� srnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and = Initiating Devices No.of Ranges No. of Air Cond. Tom • Tons No.of Alerting Devices J No.of Waste Disposers Heat Pump I Number Tons KW No.of Self-Contained Totals: Detection/Alertinh Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal CI No.of Dryers Heating Appliances , Security S stemshon O�� No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - 0 OTHER: 11 No.of Devices or Equivalent — Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work Work to Start:�,� (When required by municipal policy.) 'f Inspections to be requested in accordance with MEC Rule I0,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 r undersigned certifies that such covers in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER I certify, under the pains nd penalties ofper' (Specify:) FIRM NAME: ��that the in rmatio on this application is true and complete. Licensee: �,, Os C �`-- LIC.NO.: Arr±i_13 (Ifappllcable,enter"exempt ber line.) in the liceru Signature LIC.NO.: Address: Bus.Tel.No.• l J Per M.G.L. c. 147 s.57-61,security work requires D Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I Department of Public Safety S"License: Lic. No. required by law. Bymysignatuream aware that the Licensee does not have the liability insurance coverage n� o S Owner/Agent below,I hereby waive this requirement I am the(check one ❑owner o Signature ❑owner's a ent_ Telephone No. PERMIT FEE: $ 50 --