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Home My WebLink AboutBlde-21-007125 �. Commonwealth of Official Use Only f1 Massachusetts Permit No. BLDE-21-007125 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:6/8/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm th clrlcal work described blow. /� Location(Street&Number) 32 COUNTRY CLUB DR 7(J ii4/J f" ll,c V 1\J/I A Owner or Tenant Telephone No. Owner's Address 32 COUNTRY CLUB DR,SOUTH YARMOUTH, MA 02664 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: Replacement HVAC&steam generator for shower. 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 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 1 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 1 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: THEODORE H FITZGERALD Licensee: Theodore H Fitzgerald Signature LIC.NO.: 38794 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:43 THORNBERRY CIR, MASHPEE MA 026493342 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:$50.00 ^o (61(7-1 , �v d ! 2g2e, ea&o`///aeeachueeit`e Official Use Only . q ..?ire 7 �a fl Permit No. Tit REVENTION REGULATIONS Wulf Occupancy and Fee Checked Rev.1/07] (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: (o , '9- . Z.o 2__1 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 2 2, b Owner or Tenant 5(.)s g^J MC L/J N A Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No (Check Appropriate Box) Purpose of Building DWELL N( — 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 Location and Nature of Proposed Electrical Work: li j 1 tZE PS A ? l'• j Q 4Ct t ttic.- wMi -(L f b -sTakm Ups tr +-t,(L ,§=s4-421vveil- ' vi Completion of thefollowing table mt be waived ll) by_the Inspector of Wires. No.of Recessed Luminaires No.of Cdl.-Snap.(Paddle)Fans No.of l Z. Transformers KVA VA No.of Luminaire Outlets No.of Hot Tubs Generators KVA r1 d- No.of Luminaires Swimming Pool gr Above ❑ In- ❑ No.of I mergency Lighting and. Srnd. Battery Units No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS INo.of Zones -No.of Detection and No.of Switches No.of Gas Burners Initiating Devices 4. I I.! No.of Ranges No.of Mr Cond. Tonsi No.of Alerting Devices No.of Waste Disposers treat Pump Number Tons KW No.of Self-Contained Totals:�"'µ""""` ""�"'Y" ` .. Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ ' No.of Dryers Heating Appliances KW Security Syystems:4 No.of Water KW No.of No.of Data WiriDevices or Equivalent Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromseasage Bathtabd 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: '(P 1-4,(LA 4 1 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify,under the pains and pen ltie pf perjury,that the information• .t on this application is true and complete. FIRM NAME: w 1srV LIC.NO.: �— Licensee: Signature (!f a ress:bl � the I' number line.) Mt� w LIC.NO.: Address: 4- i`— 026�y .TeL No. �P � *Per M.G.L.c. 147,s.57-61,security work requires Mt.TeL No.: 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 II owner's a:ent. Owner/Agent Signature Telephone No. PERMIT FEE:$