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Home My WebLink AboutBlde-19-002409 ov ; Commonwealth of Official Use Only ��. Massachusetts Permit No. BLDE 19-002409 tit �•� 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:10/23/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm theje petnccal work described below. —� Location(Street&Number) 103 MID-TECH DR UNIT A 1�-{ LL- 1 d 5 eb 40 2Owner or Tenant Telephone o. Owner's Address 103-A MID TECH DR,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check.,opriate Box) Purpose of Building Utility Authorization No. / Existing Service Amps Volts Overhead 0 Undgrd ❑ No i lik , = � New Service Amps Volts Overhead 0 Undgrd , Air Number of Feeders and Ampacity 'v I�'�J 8 Location and Nature of Proposed Electrical Work: Upgrade lighting ` �i O i• Completion of the following table may be . - ctor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of al Transformers A 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 In►tiatine 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 Sins 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Paul M Morris Licensee: Paul M Morris Signature LIC.NO.: 17520 at-applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 213,1 COUNTRY WAY,SAGAMORE MA 025610213 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: $80.00 Commonwealth.of{ty�a lac et Omni Use Unty ¢� ,t cc�� cc77� �`7- -f 0 ,_ _ Permit No. �— _ 2 A ` 2 epartmant o/.g'ira Jeri ce4 Occupancy and Fee Checked r` �+ BOARD OF FIRE PREVENTION REGULATIONS I . 1/07] •'�� (leave blank) APT LOCATION FOR PE; ,MIT TO PERFORM ELECTRICAL WO K 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: a b IiL,L9 City or Town of: tru le•_ To the Inspector of Tire.: By this application the undersigned yes notice of his r her intention to perform the electrical work described below. Location(Street&Number) r k)'3 ►a �t A pt., /' pc- Owner or Tenant 1 .-Lc- „La S CA) p,(, A pi a c S Telephone No.471' '7 7 e . Owner's Address J—c)e..I 7 ._ �1-�� r 2,28 Is this permit in conjunction with a building permit? es ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead n Undgrd b ❑ 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: R,�1 1 I tom' �Q, �Ci k4 Q_{4 C.i(�� I I ��U4S�- Completion of the followinvable mot,be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lumninaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad, grad. lBattery 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 Tot No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices Heat Pump Number ,Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KWLocal❑ Municipal Connection u Other No.of Dryers Heating Appliances KVV Security Systems:' No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: 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 Iffirer. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections weitesmquested 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 EI, BOND 0 OTHER 0 (Specify:) I certi.O,render a pains atrd�enaltfes of perjrrrp,that the information on this application is true and complete. FIRM NAME: L• ' Ell_�!'f1 l Q C-t'>`Z (_ 1 ( �N LIC.NO.: Licensee _l p2P__I C Signature/�ls, � LIC.NO.: J'152.c k (Ifapplica i ear r•"exempt"in the l erase number line.) No.: ca O � Bus.Tel. 5t7`� '7 n 6 �6 Iy Address: 0 L1j z- . '`,K►2, 5- i ior`►`Y)O IQ_ t\A- 07—S 61 Alt.Tel.No.: 15D% DO O L 39 *Per M.G.L.c. 147,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)0 owner ❑owner's agent. Owner/Agent a Signature PERMIT FEE: S1.0 Telephone No. m m e.i L.`_;1-tom t c._. '' 0.4i-p_r, 0-4--A , 111 e.0