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Home My WebLink AboutE-20-3201 Commonwealth of Official Use Only �E` t Massachusetts Permit No. BLDE-20-003201 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:12/4/2019 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 electrical work described below. Location(Street&Number) 340 HIGGINS CROWELL RD Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463 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: Re-bar inspection 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. gzrnd. 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/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: Arthur P Doherty Licensee: Arthur P Doherty Signature LIC.NO.: 17197 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:372 YARMOUTH RD, HYANNIS MA 026012043 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: $0.00 Commonwealth of Massachusetts Official Use Only a c ( -= = Zep f. •ire Serviced Permit No. C�J / arfine v • BOARD OF FIRE PREVENTION REGULATIONS .O 0 cY and Fee Checked �/ ea„blank MI 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:'527 CMR 1 zoo City or Town of: YARMOUTH 2�J 9 By this application the Emdersi ed To the nspector of Fi es: gn gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) i - v e. Owner.or Tenant Owner's Address Telepb ne No. Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building ❑ (Check Appropriate Box) Utility Authorization No. r,..•--x.V._..,' Existing Service Amps / F Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0,- ❑ Undgrd ❑ No,of Meters Number of Feeders and Ampacity U Location and Nature of Proposed Electrical Work: r C i'l Fd ro 0 ;)J /� eC✓ aA] T �fnt�aJ Completion of the following table may be waived by the Inspector of Aires. 0 _ - - .4 No.of Recessed Luminaires No.of Cei1.-Susp.(Paddle)Fans No.of Total _._.._._..._.....-..._� _ aTransformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA - • Na.of Luminaires Swimtnia Pool Above ID In- No.of>rrmergency Lighting - gerred. mod. Battery IInfts No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Inflating_Devices No.of Ranges No.of Air Coed. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons 1 ICW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local Q Municipal - Conne:ction ❑ Omer No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters No.of ' Data Wiring: - Signs Ballasts No.of Devices or Equivalent ` No.Hydr•omassage Bathtubs No.of Motors Total HP Telecommunications Wirtng: OTHER: No.of Devices or Equivalent 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: p p �'•) 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" undersigned certifies that such coverage is in force,and has exhibited pro ame to the oermit r its substantial ssui goffi�valent The CHECK ONE: INSURANCE 0 BOND 0 OTHER ❑ (Specify:) f certify,under the pains and penalties of r35 that the information on this application is true and complete.. FIRM NAME:g/i75;DP. 11ex7ri cA L GoAirr-o.c_1 Cs LIC.NO.: Licensee: Jei �,,� 5 it) Signature �— (If applicable,enter"exempt"in the license number line.) LIC.NO.: . Address: 37L ye„r-ry,o✓T/.I ,� gy,A J .i, S /'I0. OZ.C�01 Bus.Tel.No.: - p j `Per M.G.L. c. 147,s.57-61,security work requites Department of Public SafetyAtt.Tel.No.: / — OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liabilityLin.No. � insurance coverage normally required by law. By my signature below,I hereby waive this requirement I am the(check one ❑owner ❑owner's ascot_ t Owner/Agent t Signature