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Home My WebLink AboutBLDE-21-001284 Commonwealth of Official Use Only ...task\ Lxvis Massachusetts Permit No. BLDE-21-001284 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:9/14/2020 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) 38 GARDINER LN Owner or Tenant BRICKLEY CRAIG Telephone No. Owner's Address BRICKLEY ROBIN, 19 MEADOWVIEW RD, EVERETT, MA 02149 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appr' •*' x) // Purpose of Building Utility Authorization No. (( Existing Service Amps Volts Overhead 0 Undgrd 0 S j — New Service 100 Amps Volts Overhead 0 Undgrd 0 .4f. s Irn1� Number of Feeders and Ampacity 'VI Location and Nature of Proposed Electrical Work: Wiring for A/C system&service upgrade. Q ift2:7 Completion of the following table may be waived by 1,4,,e, • • Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 1 Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 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 Initiating 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 ❑ 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 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: WILLIAM C FLIGG Licensee: William C Fligg Signature LIC.NO.: 12584 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:55 FREEMAN RD,YARMOUTH PORT MA 026752304 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 Cmunonwsaith o///Iamachua.Ao Official Use Only OZt - t 2*3 4 ''- u.5 c� n Permit No. • ' �[Jepart`ir eni oo.}iro Serviced _ _ l y `r BOARD OF FIRE PREVENTION REGULATIONS [Rev. 7] (ly Fee Checked _..�" (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Cods�^ (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: `I 14'L. City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned Ives notigs,ofhis or intention to perform the electrical work described below. Location(Street 8 umber) r r— Owner or Tenant Q_fry\ N`\ t; V.A1 Telephone No. Owner's Address • Is this permit in conjunction with a building permit? Yes ❑ NrCheck Appropriate Box) Purpose of Building U Authorization No. Existing Service Amps I.7 / Z`► tVolts Overhead Undgrd❑ No.of Meters JYew Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: g.r,,r.t- .�Je..._C�/%ox b A ic am Completion of the follawing.tabk may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Cefl.-Susp.(Paddle)Fans Trf Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting Sind. grad Battery Units ti 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 II-1 No.of Ranges No.of Air Cond. Tons No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons ...Kw __. No.of Self-Contained Totals: ' Detection/AlertIngDevIces No.of Dishwashers Space/Area Heating KW Local❑ Municipalonnection 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 Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP ' Telecommunicatf ns 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:1 j —ZG 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., 13OND 0 OTHER 0 (Specify:) I certify,under,the pains and penalties otplurp,that the anon this application is true and complete. FIRM NAME: `\. .0�v- 1 —(....CA-1—N.C�Q r LIC.NO.: r 5- —13 Licensee: re LIC.NO.: (If applicable.enter"exempt"in the license number line.) �y VIy T 1 Address: Bus.TeL No.: Alt.TeL No.: *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 I Signature Telephone No. 1 PERMIT FEE:$