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Home My WebLink AboutBlde-20-003008 Commonwealth of Official Use Only TE. ! 0Massachusetts Permit No. BLDE-20-003008 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:11/22/2019 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 cribed below. Location(Street&Number) 27 MCGEE ST jv rt-l-1 iv (v 02004 Owner or Tenant Miillit000451,1VICIEIELLN Telephone No. Owner's Address 27 MCGEE ST,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 60 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: Service upgrade. 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. 'gill.; 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 tcc- 4 ( 4(q ( . I smolt Commonwealth.e/'addachuoatto Official Use Only Q _1 G Permit No. e r �v . a `.2spartmani of.. ire Serviced �ry7 / p l =- , 1i- Occupancy and Fee Checked Uv�W BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) 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 INFORM4TION) Date: / I �JCCityor Town of: To the Ins ector Wires: Vlesi(P\4101 YARMOUTH p of By this application the undersigned gives notice of his or her intention to perform the electrical work described below. c/ I Location(Street&Number) 17 c c; c e ..j ce(�' 1- Owner or Tenant , el-till „W �Y�p y\ Telephone No.50,6-01f e:)7f 0 V Owner's Address Is this permit in conjunction with a building permit? Yes El No (Check Appropriate Box) Purpose of Building /1 G vL C Utility Authorization No. Existing Service 6'O Amps /2 fi 1 2 4.UVolts Overhead Undgrd❑ No.of Meters 1 New Service /vd Amps IZ D / 2000Volts Overhead/i Undgrd❑ No.of Meters Number of Feeders and Ampacity Locationa ature of Propos Electrical Work: e u/ c - 4c1.w :._ 6 ar e- S�b pa c f 9 /tea � d,�,re e '� / Completiotrof the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires t5 No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets •3 No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of I mergency 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. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other 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. • imated Value of Electrical Work: c/ ,;ip (When required by municipal policy.) i ork to Start:13/L ,/i ei Inspections to be requested in accordance with MEC Rule 10,and upon completion. "._ s SURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless r e licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The ..4 Q dersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. I HECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) ` 3 certify,under the pains and penalties of per'ury,t °t the information on this application is true and complete. o z NAME: k31o] u/ �6iG{ On LIC.NO.55' 'O In '-J iceasee: 5 5 g 30-8 Signature LIC.NO.:3.83 o—l5' lzk _ f applicable,enter"exempt"in the license number line.) G Bus.Tel.No.. n,�a..............- _ ddress: 2, frOC e e t/. ��.. Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,securit work requires Dep ent of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that he 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 agent. Owner/Agent Signature Telephone No. PERMIT FEE: $