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Home My WebLink AboutBlde-19-005146 Commonwealth of Official Use Only R Permit No. BLDE-19-005146 . Massachusetts 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:3/13/2019 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) 476 ROUTE 28 Owner or Tenant THE POINT LLC Telephone No. Owner's Address 476 ROUTE 28,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 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: Take over from another electrician to complete job. 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 of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting 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: Mark F Patterson Licensee: Mark F Patterson Signature LIC.NO.: 21571 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:3 OLD FARM RD,WALPOLE MA 020812504 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 iature Telephone No. PERMIT FEE: $2,800.00 _ _ lcommoruveatth of�j / le_=:_.t cc�� c/�//assnaciucssf i • Off�ici]al(U�se Only `� A4,'�� JJaParlmcnt of lira Jawrw Permit No. Jj\ `L S BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. l/07] (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: '3 Ss"" 9 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) 9'7(0 ,n S)--, Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes tsi, No . El (Check Appropriate Box) Purpose of Building . -A ea*txp.A,un Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd gr ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: VIA..ej, C Completion of the following.table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Snsp.(Paddle)Fans No.of Total Transformers KVA No. of Lurninaire Outlets No.of Hot Tubs Generators KVA `., No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting arnd. arnd. ❑ Battery Units No.of Receptacle Outlets No.of Ott Burners FIRE ALARMS INo.of Zones T No.of Switches No.of Gas Burners 'No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons `KW No.of Self-Contained Totals: f Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances , 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 Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of E ec cal Work: 1[,.. (When required by municipal policy.) Work to Start: 3 S i 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 c verage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER I certify, under the pains and enalties oIPer! ry u that the information(Specify:) this application is true and complete.. FIRM NAME: 14 , .1. 1 , 77t'7 I Licensee: � � '/_/• t LIC.N0.: Signature - —__ LIC.NO.: (ZS�!t (If applicable.enter"ere pt"i e license number line) Address: 3 d1a� Bus.Tel.No.: j Per M.G.L.c. 147 s.57-61,security work requires Dep ei A' (''ZP' Alt Tel No:SUS ent of blic Safe 7S- OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance overage nnorma required by law. By my signature below,I hereby waive this requirement I am the(check one ❑owner Owner/Agental ❑owner's a ent Signature Teleph•onq No. PERMIT FEE: $