HomeMy WebLinkAboutBlde-20-005026 Commonwealth of Official Use Only
E. ,i Massachusetts Permit No. BLDE-20-005026
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:3/11/2020
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) 32 OLD CHURCH ST
Owner or Tenant BARNATT JUDITH EVANS TR Telephone No.
Owner's Address JUDITH E BARNATT REVOCABLE LVG TRUST, P 0 BOX 261,YA OUTH PORT, MA 02675
Is this permit in conjunction with a building permit? Yes 0 No -• ck Appropriate Box)
Purpose of Building Utility Auth r ''
Existing Service Amps Volts Overhead 0 U g 1 ii o.o- ' :ers
New Service Amps Volts Overhead 0 Undgrd lh No. i i♦•0 iiii
Number of Feeders and Ampacity
19Er
Location and Nature of Proposed Electrical Work: Renovations per attached.
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 14 No.of Ceil.-Susp.(Paddle)Fans 1 No.of Total.
Transformed S� KVA
No.of Luminaire Outlets No.of Hot Tubs Gener; ir ' 1 A
No.of Luminaires Swimming Pool Above ❑ In- ❑ No. I ��• : ' g
grnd. grnd. Batt
No.of Receptacle Outlets 36 No.of Oil Burners FIRE AL• 1. i ' 1 n
No.of Switches 16 No.of Gas Burners 1 No.of Detection and
Initiating Devices
No.of Ranges 1 No.of Air Cond. 1 Total 2 No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 7
Totals: Detection/Alerting Devices
No.of Dishwashers 1 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: 3
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:) 1 74' (J'7 — 2
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Bryant K Dundon
Licensee: Bryant K Dundon Signature LIC.NO.: 53109
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:67 TAURUS DR, MASHPEE MA 026493458 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: $75.00
UVC-Ati"
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14
4 ..,.. ..._ 'i c� c� {� Permit No. i
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.:.'' '•.. .GJsloarlmeni o`.}in Serviced
I{ Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [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: `-~ /./_ ?C
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of hispr her intention to perform the electrical work described below.
Location(Street&Number) o` /> _4 /1 --/
Owner or Tenant I/£„„6 t SC() ,/1,'_ Telephone No.77),99'/G7Z
Owner's Address 3 2 (YlO C j,„iG z. '/
Is this permit in conjunctioth a building permit? Yes ❑V No 0 (Check Appropriate Box)
Purpose of Building 5.6.14./7'i �� Utility Authorization No.
Existing Service7",) Amps 0-../ yC/Volts Overhead❑ Undgrd No.of Meters
ENew Service Amps / Volts Overhead 0 Undgr 0 No.of Meters
Number of Feeders and Ampadty 3 6� / /
Location and Nature of Proposed Electrical Work: <ro-?O vri it G/7 i_.tl,.n e>�e. /9/.21 / 4
Completion of the followgin table maybe waived by the Invector of Wires. t
No.of Recessed Luminaires !9 No.of Ca.-Slop.(Paddle)Fans J No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
k No.of Luminaires q SwimmingPool Above In- Bat of Emergency Lighting
and. ❑ grnd. ❑ Battery Units
� No.of Receptacle Outlets 3c No.of Oil Burners FIRE ALARMS No.of Zones
vs-~ No.of Switches No.of Gas Burners 'No.of Detection and 7 -
�� 4Initiating Devices
114 No.of Ranges / No.of Air Cond. j Tonal No.of Alerting Devices
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 Monnectionunidp 0
Other
C
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Sys Ballasts No.of Devices or Equivalent 3
_ No.Hydromassage Bathtubs No.of Motors Total HP � Telecommunications Wiring:
_ ___Y___ No.of Devices or Equivalent
. `' ,.,.. z OTHER:
f�Q ,�N Attach additional detail if desired,or as required by the Inspector of Wires.
z stimated Value of Electrical Work: „lei 7C�0,(When required by municipal policy.)
' ,7; a 1 ork to Start: F Inspections to be requested in accordance with MEC Rule 10,and upon completion.
NSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
6 ,the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
�• ?�� iirndersi ed certifies that such coy,� ,� gn :ge is in force,and has exhibited proof of same to the permit issuing office.
,= ❑ OTHER 0 (Specify:)
�'M �. o HECK ONE: INSURANCE Its BOND
r',L . 4L__a certify,under the ins and, nalties erjury, hat the in ormation on this application is true and complete.
__.. _. 1'IRM NAME: , — rci4%G-tit-, LIC.NO.:55/0 7
Licensee: t.�,,��,,, Sign LIC.NO.: e 3/61
(If applicab ee, er rpt"in the license number line.) Bus.Tel.No.; 7 ,,�
Address: tr>- T v�.,. .'fir- r <.TeL No.: 7 y C
*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 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$