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HomeMy WebLinkAboutBlde-22-003201 or Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-003201 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:12/6/2021 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) 1067 ROUTE 28 Owner or Tenant MULLEN MARY ANGUS Telephone No. Owner's Address C/O RYANS FAMILY AMUSEMENTS, 1067 ROUTE 28,SOUTH YARMOUTH, MA 02664-4105 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 ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade lighting&outlets 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 rnd. rnd. 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 Initiatinc Devices No.of Ranges No.of Air Cond. Tn 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 ❑ 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 Siens 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: Arthur P Doherty Licensee: Arthur P Doherty Signature LIC.NO.: 17197 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:372 YARMOUTH RD, HYANNIS MA 026012043 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 ❑ owner's agent. Owner/Agent Signature Telephone No. / PERMIT FEE: $1.040.00 A101--(� Z 1a12Jz{ /ke �1 t(I7rr/C LLAJ (CA I teen #4..0 ergt c Ems- 1 l6/7vz rE (.14e"C) #221-2;2.- F1,4 P-1r✓ I or (Ns .�' L D Commoniusailh o/'aeeac1 aeetto Official Use Only A� '� Permit No. "C'ZZ 3 Z� L it _ t oj��.t; Occupancy and Fee Checked ,.' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) Z' 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 TYP ALL INFORMATION) Date: h?-/3-/09--0 City or Town of: Odin DI,(,h To the Inspector of Wires: eo By this application the undersigned 'ves notice of his or her intention to perform the electrical work described below. �q Location(Street&Number) /Q l y l gatt p2 g-- Ti'r tlQ 'm Tf[,t l • Owner or Tenant R'%Ji f j III' A ,,,("e�I€�'f 1 / Telephone No. Owner's Address WO /ell kilt � k ,c'a bull, yai-in iM"-A 'U.'l Do24& e/ Is this permit in conjunctionn_ with a building permit? Yes 0 No El (Check Appropriate Box) Purpose of Building (.U/Y)IYr e f Gtil.� Utility Authorization No. © Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters N New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters �' Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: f(4 d i h q u u- /e- t. 'ia 0, IV Completion of the followingtable may be waived by the Inspector of Wires. vl No.of otal tlb No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers TKVA rl No.of Luminaire Outlets No.of Hot Tubs Generators KVA Cr No.of Luminaires SwimmingPool Above ❑ In- ❑ Ba• a Unitsency Lighting Md. grnd. Battery Units `tl No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and " No.of Switches No.of Gas Burners Initiating Devices 1l.i No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices M No.of Dishwashers Space/Area Heating KW Local❑ Conneunlcipction ❑ Dcher No.of Dryers Heating Appliances KW Securi * No. f Devices:or Equivalent No.of Water "No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Wiring: No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNo.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: 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:) bo Wi/h 14 0 Weil I certify,under the pains and• na/ties of perjury,that the informationon this applicati'is true . ' complete. FIRM NAME: BG.1.(1/ t �[ecf- r e DJ I.f n art / 0.: 417197 Licensee: /"f l't- 1 Li l' p. boy Iv Signatu /. .. ,: s.: (If applicable,enter"exempt"i the license n bee line.) ,f r ,' i s. el.No.: S03-771"7a2.70 Address: _`l77 fit;d iet,� DK WP�S+ tLYfunvt-41 �� t Z3 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$4 0 1D.OD