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Home My WebLink AboutE-20-0636 3\1 Commonwealth of Official Use Only ' �`- c,, Massachusetts Permit No. BLDE-20-000636 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:8/5/2019 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 electrical work described below. Location(Street&Number) 248 CAMP ST UNIT L2 / Q(U Ovrat —7-13WfL Owner or Tenant TATARCZUK THOMAS F JR Telephone No. Owner's Address 906 SUMNER ST, STOUGHTON, MA 02072 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: Miscellaneous repairs per attached. 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 grad. 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 ❑ 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: Dennis Duty Licensee: Dennis Duty Signature LIC.NO.: 51588 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 10 MERCURY DR,S YARMOUTH MA 026644129 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: $50.00 9! 1 e( 7/( q - Commonwealth of///a6sachWsttl • Official Use Only _s+' = Permit No. 1' Zd 66 (O 2epartment o/.fit,.Serves BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. l/071 (leave blank) APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: �f 11 57 l 2.00 City or Town of: YARMOUTH e To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. . Location(Street&Number) - , 9 ( .' '/a .0%A • � (� M.S.' -X- Owner or Tenant LLt., t e- -v T'o w `r1 G Olt Telephone No.3 a g'-r'-7 U,!-'$� Owner's Address ?. 48 ( t AR ST U_3.' `!/�R y`, . ts �( 6.ss Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service t 5 D Amps j)D I,.,44a Volts Overhead ❑ Undgrd No.of Meters / New Service Amps / Volts Overhead❑ Undgrd gr ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ^,� y- _ pins-Toes Pe Ai.id�s,ast9EBDIs ,`i t C, �� C C.t 16'rl tl� S�C� �t� �.��L�r� ti Completion of the following table may be waived by Me Inspector o Wiresfrf C(at, No.of Recessed Luminaires No.of Ceti-Susp.(Paddle)Fans No.of Total 1-1. -t' Transformers I{VA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Pool No.of Luminaires Swimmittg Above In- No,of i✓mergeacy Lighttag - d. ❑ rrnd. 0 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. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump 1 Number I Tons I KW No.of Self-Contained Totals: Detection/AiertinuDevices No.of Dishwashers Space/Area Heating KW �Local❑ Municipal - Connection ❑ Otlt� No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - OTHER: No.of Devices or Equivalent - Estimated Value f 1 cal Work'' �� Q Attach additional detail(desired or as required by the Inspector of Wires. Work to Start: A. / (When required by municipal policy.) Inspections 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 covep.ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE a BOND ❑ OTHER ❑ (Specify:) I certify, under the pains andpenalties o ��) fperjury,that the information on this application is true and complete.FIRM NAME: Licensee: fl+s -� LIC.NO.: Signature (If applicable,enter es t in the license number line.) �11) LIC.NO.: � . Address. /D t44- Al `PR; 5 y6�w�- -"' Bus.Tel.No.: -D7 6 _j `Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety Alt.TeI.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilityLin.No. � insurance coverage normally 5 required by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner ❑owner's agent. Owner/Agent 1 Signature Telephone No. [PERMIT FEE: $