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Home My WebLink AboutBlde-20-002109 Commonwealth of Official Use Only �� Massachusetts Permit No. BLDE-20-002109 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:10/16/2019 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) 303 ROUTE 6A Owner or Tenant VUONO THOMAS G Telephone No. Owner's Address VUONO WILMA D, 303 ROUTE 6A,YARMOUTH PORT, MA 02675 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 ❑ 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: Wiring for office. 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 ❑ 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: Steven E Tullock Licensee: Steven E Tullock Signature LIC.NO.: 20114 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:4 RUTH ST, HARWICH MA 026451674 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: $75.00 6.19-ikDIttr 1(1 (7-6 (cicreig. cgoe) ee.v (O/7v/f9 f# Fi l 244(1 M- f Comnsonwea[h of//laaaachuaslfa Official Use Only �9-'t c� c7 n Permit No. "--�6J ! .. '_. 3spartmsnl o�,.tirs Jsrvies,' 1 i Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. (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 INFORMATION) Date: t D)i(P [2c, t Qf 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) 3 C.DiS er. f.,,A -..(442}--(tJ vT f z Cr Owner or Tenant M C-H So l K i Q44 N p V Telephone No. $ g 4 er' `i 10) Owner's Address � fl K t Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building *P.&'S t" ..t T(A L Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty Lefl— Completiondon and Na re of Proposed Electrical Work: �t e t tV kr 1-1 E.tnr t.FP) g tom/ ,,, of the followin table may be waived by the Inspector of Wires. �'� No.of Total U No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmingpool 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 AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons _KW No.of Self-Contained Totals: Detection/Alertin Devices Municipal ' No.of Dishwashers Space/Area Heating KW Local 0 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 R: Ci Z Attach additional detail if desired,or as required by the Inspector of Wires. LU 5u-E rn �st mated Value of Electrical Work: (When required by municipal policy.) 1 c W k to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. i cet QI URANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless — ' cc) !;the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The Lu 1 igned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. C) ' :zC CK ONE: INSURANCE 0 BOND ❑ OTHER 0 (Specify:) w 1^I�+ rtify,under the sand penalties so f�erjury,that the information o►r this application is true and complete. �, ;Ili NAME: �T�V E \ ) S( c Z LIC.NO.: Li nsee: "5-1---fv c.• ---\ v c.tczEttipature LIC.NOR '111-4 ltk (If applicable,ent r' m 'tote license numb li e. £S T a y%-› tQ.Q Ell - ll'tAbbt i j Tel.No.: f�3 �0 2-3'1 2 1,p Address: TeL No.: *Per M.G.L.c. 47,s.57-61,security work requires 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)[]owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$