HomeMy WebLinkAboutBlde-20-002980 Commonwealth of Official Use Only
Permit No. BLDE-20-002990
Massachusetts
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
JRev.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 pertorm the clectncai work described below.
Location(Street&Number) 243 OLD MAIN ST
Owner or Tenant MCNAMARA KEVIN M Telephone No.
Owner's Address MCNAMARA MARGARET R,243 OLD MAIN STREET, SOUTH YARMOUTH, MA 02664
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 ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Receptacle for water heater.
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 0 In- ❑ No.of Emergency Lighting
grnd. grnd. Batter,Units
No.of Receptacle Outlets 1 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 ❑ 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: JOHN WEISS
Licensee: JOHN WEISS Signature LIC.NO.: 53846
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:63 UNCLE BOBS WY, SOUTH DENNIS MA 02660 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
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Comnwnwea[th o/Ma:macltit:se is tOfficial,Use Only
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2sparfinenf o`..tiro Serviced
', BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM EL CTRI AL WORK
All work to be performed in accordance with the Massachusetts Electrical Code( C),527 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: e .9/ /
City or Town of: YARMOUTH To the I pector f Wires:
By this application the undersigned gives notice2 of his her intention/to perform the electrical work described below.
Location(Street&Number) A��J GA/ �a,/ , si - 'y/3 -..stuff;
Owner or Tenant #frt2/'C'i Telephone No. �'
Owner's Address 4.L/C�,' (yip 1,..ic ii f✓ Toot 'ohs—tatui 77`/7Zvor
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❑ Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: i:i.:.;7i — -/�t " _
. /�,,
i
r>.�� ^_.:-�.., _ s�'��i.Nr.7► - 6.PI' FOP •i"' /c
`r Completion of the followingtable mery be waived by the Inspector of Wires. /h3 p1,
5: No.of Recessed Luminaires No.of CeiL-Sosp.(Paddle)Fans No. Total �►pT
,,, Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting
_trnd. ❑ 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
c Initiating Devices
.' No.of Ranges No.of Air Cond. Total No.of AlertingDevices
Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: ""' ""'""" Detection/Alertin Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑
Connection 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,
Estimated Value of E ctri Work: (When required by municipal policy.)
Work to Start: a Inspecti s to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE C GE: 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 ot BOND 0 OTHER ❑ (Specify:)
I certify,under the p ins and penalties of a dory,that the information on this application is true and complete.
FIRM NAME• J it/i (^/e E LIC .:2 2aa2^/y
Licensee: 76ittn (;✓e, Signature LIC.NO.:�v�
(If applicable r" pt;i the 'ce ber line.) �, Bus.Tel.No.•.reY2 •5 Jf3 3/4'
Address: (p,f 4C- r ,--p Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requids 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
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:$