HomeMy WebLinkAboutBlde-20-002556 Commonwealth of Official Use Only
Permit No. BLDE-20-002556
iE 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:11/1/2019
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her mtenho ertorm the electrical ork described below.
Location(Street&Number) 92 ROUTE 6A N
Owner or Tenan K _ Telephone No.
Owner's Address ,92 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 0 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: Final inspection for closed out permit.
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 3 No.of Ceil.-Susp.(Paddle)Fans No.of Total
:
Transformers KVA
No.of Luminaire Outlets 10 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 14 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 7 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 Siens 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: Jarlath A Galvin
Licensee: Jarlath A Galvin Signature LIC.NO.: 10861
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 100 ACORN DR, OSTERVILLE MA 026551370 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 CI owner's agent.
Owner/Agent
Signature Telephone No. I
1 I PERMIT FEE:$50.00
g4 Commonwsa[th of Maeaachuesffa Official Use Only
).\-1.\(-1 '..•7''B- ,t �LJs/varfmsnf Permit No. L`'� ZSC ZP
-e:; of girl Serviced
`1 - BOARD OF FIRE PREVENTION REGULATIONS [ReOcvan.0/07] and Fee Checked
'�`', � (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Co4e(ME i)4527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ou I VI
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives i otice of his or er°mention to perform the a ctrical work described below.
Location(Street& umber) ' 2, 4. S I �6 Ar \ ajZvus ft
Owner or TenantOby� c, '� i Telephone No. S0$ 33Z f.t
Owner's Address r Nit
Is this permit in conjunction with a building permit? Yes [ ' No ❑ (Check Appropriate Box)
Purpose of Building t gja 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 Ampacity
Location and Nature of Proposed Electrical Work: e4. 4,t &�t — V c ^cliv,i 't-
\ff Completion of the following table may be waived by the Inspector of Wires.
otal
1w, No.of Recessed Luminaires .3 No.of Ceil:Susp.(Paddle)FansTf
Transformers KVA
No.of Luminaire Outlets it* No.of Hot Tubs Generators KVA
No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting
�rnd. ❑ ❑
Rrnd. Battery Units
No.of Receptacle Outlets i Li No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of GasBurners No.of Detection and
9. Initiatina 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 0 Municipal ❑ Othea
Connection
No.of Dryers Heating Appliances Security Systems:*
KW
�-- No.of Devices or Equivalent
-�PIe.of Water No.of No.of
; ' Heaters KW Data Wiring:
—_ Signs Ballasts No.of Devices or Equivalent
i 1 �_,., . Io./ ydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: =
I No.of Devices or Equivalent
nf3 R:
L1,4>t1Attach additional detail if desired,or as required by the Inspector of Wires.
P ,, :' ati elated Value of Electrical Work
. �t,000 (When required by municipal policy.)
I. JZ Vd1'k to Start: Cp�RQ to be requested in accordance with MEC Rule 10,and upon completion.
LL�7 ;SIN URANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
it n �j J the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
m ttrt$ersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
---- --HECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:)
I certify,under the ains and penaltie of pertry,that the inform lion on this application is true and complete.
FIRM NAME AD.I.A tK U)h►' LIC.NO.:,Qe6I 5
Licensee:_Sp1Q $. G.µel N uswid
Signature , / . visa LIC.NO.: 0 f 6
(If app/icablkln(er" mpt n he ens nuts 1' e.) l Am.
Bus.Tel.No..SO ��}-
Address: ((�� l �J Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department o Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)CI owner ❑owner's agent.
Owner/Agent I
Signature Telephone No. f PERMIT FEE:$
Elliott, Ken
From: Cipro, Linda
Sent: Wednesday, November 6, 2019 4:18 PM
To: Hall, Lee; Elliott, Ken; Inkley, Brad; Moriarty,Jason; Huck, Kevin; Renaud, Philip; Murphy,
Bruce
Subject: final for occupancy 161 Route 6A
Good Afternoon All,
The Building Department is scheduled to conduct a final for occupancy inspection < u' ;:'yoga
studio on : - 11112/141#nd would like for you to attend. The contact person is Deborah and she cannbe reached
at 508-681-5308. Please notify me regarding your inspection results.
Thank you,
Linda
iq C61.._
1