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Home My WebLink AboutE-18-3108 Commonwealth of Official Use Only fE�' !►i Massachusetts Permit No. BLDE-18-003108 • BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/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:11/24/2017 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) 507 BUCK ISLAND RD Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address 1146 ROUTE 28, SOUTH YARMOUTH,MA 02664-4463 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Checkgppyo.Hate Box) Purpose of Building Utility Authorization No Existing Service Amps Volts Overhead 0 Undgrd re N l •� New Service Amps Volts Overhead 0 Undgrd o i Number of Feeders and Ampacity , ,U� Location and Nature of Proposed Electrical Work: Relocate&add lighting fixtures to service bays. I � � 0� °`11C• � / Completion of the following tab e May be bpector of Wires. No.of Recessed Luminaires - No.of Ceil:Susp.(Paddle)Fans No.of 40 Transformers `` KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires 4 Swimming Pool Above ❑ In- 13No.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. Toe l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons i 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 ifdesire4 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ROBERT J CARLSON Licensee: Robert J Carlson Signature LW.NO.: 38869 (If applicable,enter"exempt"in the license number line) Bus.Tel.No.: Address:39 NAUSET RD,W YARMOUTH MA 026733752 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:$0.00 '4 .. _ y - l�om,r.oawc rr� of�t/ysyne!-•.+.•fF DLnciEl Um ¢h. �Tl ararmeet o{ r.5'w:�. .•:Panrit No. C �,t )f['ti BOARD OF FIRE PREVENTION REGULATIONS fl Occupancy aFee Checked . 1/07] ' (leave blank) ---- APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work es be printed in accormttz with the Mes nr uset.Electrical Coo: (PNEP (MEC),527 cn,R 1100 RINTININYOR IYPEAIL INFOR.E4i70117 Date: //—ft-/7 City or Town of: YARMOUTH To the Inspector of PTrres: By this application the pndersig�ml s notice of his or her intention to permtm the electrical work described below. Location (Street&Number) CO 7 dpe,t fiZirte /20,4 �{ Owner•orTenant nikcim D��v/ r� � Telephone No. J Owner's Address ad Is this permit in conjunction with a building permit? Yes Purpose of Bolding � / � H0 $. �e�!+pproprise Bor) F7//it/ !/ekkg& Dtr7ity Atrthori ation No E>icatz Service�c 42 amps / en f y/�+ol's Qrerf eadgk Undgrd❑ No. of Meters 1 New Service Amps / Volts Overhmd❑ Und d Number of Fetdets and Arapacrp ❑ No. of Meters s Location and Netare of Proposed Jleeicaj Wort 7\ r i i rC .. �1 �O <A/c _�/ ,:k g.; t ��tF Coamlthan of the foTowine ••lee mel be wdved by the Inrp mor ofn urns, No.of Recessed S— No,of Cell-Stt p.(Parirtr-)Pats INo.of Total No.of Luminaire T�nO�� IaVA • OndeM Na.of Hot Tabs 'Gann-atom • L'VA ' Na-• of L>an:,..:'.. Li � Swar.�a,;Pool Al'ove ia' pro.of Y,mriscy y t��e arnd. 0 erred- o E env Units •- No.of Receptacle Octi No.of Oil Be:nett PIM ALAPkLS 171n,of Zones No.of Switches No.of Cu Enrnen LNo.of Detection and No.of Rxages I Laiiiatin>Devices Na of Air Coad. Total so,of 4Ts-Cn;Devices • Tons No.of Waste Disposers Heat?amp Number Tons 1 kW IN4 of Self-C°ntautd Totals: 1 Demction/Alertinv Devices No.of Dishwashers ❑Mt:nidpal Sp-ace/Area Heating KW Leal No.of Dryers Hera' g :� Connection 0 `S Appliances KW eturity SYrt�s:` No.of Water Na of Devzc�or&rnivala,t Heaters KW No. of No. of Sims Eatl> Data No.oof DefDevices or E4nindent No.Hydromassage Bathtubs No.of Motors Total BY Telecommunications Witmer OTHER No.of Devices or Equivalent Es hated Value of Electrical W ort^ When addrequired ons derail ideoired or CET regUired by the Inspector of Wires. Work to Start //—1/—/7 (When by mrmicipal polity.) 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 electical work may issue unless the licensee provides proof of liability inslnance inclnriing"comps operation"coverage or it substantial equivalent The undersigned certifies that such coverage is in force,and has ahrbitd proof of same to the permit issuing once. CHECK ONE: INSURANCE 0_ BOND 0 OTHER 0 (Spxify:) r cer4&,ander the ¢:,.d ppk�vr P -^s of paring,ja the inforrtafron on this applicffinn is true . , complete FERM NAME: frge>427,57 /j/ �averz ---/7 LG NO.:Licensee � 427g ` /� tz7/ D Slgnatsrt /�� (7f applicable, enter _ ,r..to fr terAdO v / LIG N0.:{, (' . Address et 7 .Al �i %/ 1/44/ Bus.Tel.No•• _ j `Per M.G.L. c. 147,s.57-61,security work Alt Td No.: 0WNER'S INSU fires Departme:ce s e does Safety"S"License•. rac No. ----- .7,7t RANGE WAIVER: I am aware that the Licensee does not have the liability insonate coverage normally t required claw. By my signature om below,I hereby waive this requirement I am the(check one 0 owner en's a eat Signature. TetephoneNo. PERMIT FEE: S