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Home My WebLink AboutBLDE-22-003332 Commonwealth of Official Use Only li Massachusetts Permit No. BLDE-22-003332 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:12/13/2021 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) 356 GREAT ISLAND RD Owner or Tenant Debora Green Telephone No. Owner's Address 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: Wiring for work out room. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 4 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- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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. � 7T� CHECK ONE:INSURANCE 0 BOND 0 OTHER CI (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 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:$75.00 ?i ,k3e,t74 (Li P.z. k RicIrt c t i t f z1 ( i 47Nc .f_ 7/ RkCEIVE DEC 10 2021 .; BUILDING DEP�- •,...u. Commonwsa&o`Mweaachwiette Official Use Only er. ;. : �N cc�� c7� C{�� Permit No. � 337/ -;A•; F �[Js/vartmsnt o`}irs Jsrvicsd _- :,',1.,1 J. 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 perfonned in accordance with the Massachusetts Electrid Code(MEC), MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat•pc, Id Z City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention t e onn electrical w k descri below. Location(Street& umber).3 s�, e AI �,S�,qN Jf �"c AP-r ' Owner or Tenant .�.,.'i=1C3PA ert.tElJt Te phone No.44 ci .:3 t 942K, i Owner's Address I Is this permit in con�ction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Q.2r►t- 1.14 IA-a0 6S.72 Utility Authorization No. Existing Service Zc ' Amps / Volts Overhead❑ Undgrd[r No.of Meters ' New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity if Location and Nature of Proposed Electrical Work: tia4L0 Jr ?,LLC r-i iji Completion of thefollowingtable my be waived by the Ins ector of Wires. tii No.of Recessed Luminaires No.of Cell:Sas No.of Total �l "-� p.(Paddle)Fans Transformers KVA 't No.of Luminaire Outlets No.of Hot Tubs Generators KVA ,i No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting trod. grad. Battery Units No.of Receptacle Outlets ..4 No.of Oil Burners FIRE ALARMS No.of Zones ~` No.of Switches I No.of Gas Burners -No.of Detection and ` Initiating Devices 1 1' No.of Ranges No.of Air Cond. Tool No.of Alerting Devices No.of Waste DisposersHeat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑ other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent KVVNo.of No.of HeatersData Wiring: 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 Val of Elec al Work: I ..art (When required by municipal policy.) Work to Start: rC� U() 21 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 cov9rage 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 penalties of perjury,that the information 'n this application is true and complete. FIRM NAME:--11Q(-A-1'1`t C torn, LIC.NO.: I_6&e,I ,11- Licensee:, rAt2LkTi.. t3A-1.uIN Signature l t r i J+'- LIC.NO.: (lf applicable,enter"exe i be license numbe line.) Bus.Tel.No. • Address: ad at..!" 61! µnv.n L.g- tt Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work rquires 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 Signature Telephone No. I PERMIT FEE:$ 76--