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Home My WebLink AboutBLDE-22-003945 „„ Commonwealth of Official Use Only �` Massachusetts Permit No. BLDE-22-003945 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:1/18/2022 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) 231 WILLOW ST Owner or Tenant CTS FIDUCIARY LLC TR Telephone No. Owner's Address TWO THIRTY-ONE WILLOW ST RLTY TRUST,231 WILLOW ST,YARMOUTH PORT, MA 02675 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 new sprinkler pump in basement. 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 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 ❑ 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 1 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. 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: IAN B JACKSON Licensee: Ian B Jackson Signature LIC.NO.: 39860 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:273 MAIN ST, HARWICH MA 026452467 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: $80.00 ct C lR W -�_ Commoruveolth of ma.6sac rid Official Use Onl _-_=1�� -/ ccam�, c �Z 01= 9. 2epartn eni /.:i,e s Permit No. Z o crrricss f= Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) ----- (leave blank) •e DDI Ir w sir", rr+�-+ .r+r-.�..._ _ - __ _. . : :. :; :-. ,_ ; i v rERrvrcm ELECTRICAL RICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(1vfEC),527 CMR 12.D0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: l r Pe' 0.2 City or Town of: YARMOUTH To the Inspector of Wires: By this application the Iiridersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) 02 3( �) 1 Orwo *r Owner or Tenant Ze Q t i et.,it K.t AN) ( G.D , TUtztJ,pn.Y\Telephone No. 50%,-�3'IS'- N,bp�- Owner's Address l,tyhc.q.r e/� J Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building .eick Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd gr E No,of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 49.,3 ( (.iJ, (�ow 5[?e I �i Cvt2.� �tt.� t' Completion of the followinvable 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 SwimmingPool Above In- No.01:l�,mergency Lighting - ornd. ❑ arnd. ❑ 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 Tans No.of Air Cond. of Alerting Devices • No.of Waste Disposers Heat Pump!Number Tons H KW No.of Self-Contained Totals:I Detection/Alerting Devices No.of Dishwashers Space/Area Heatin KW Municipal g LOB❑ Connection ❑ er No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of Heaters KW No.of Data 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 Value of Electrical Work: (gyp"— (When required by municipal policy.) Work to Start: I ((ci , EZ_ 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 coy rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [0 BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: 'MQeN g , j'a J Signatur Q (If applicable,enter"exempt"in hlicense number line) ine.) LIC. o.:NO5 �z 3 . Address. a7 1 ,,-64 R O2(,CE�' Bus.Tel.No.:. ZFA= $� J *Per M.G.L. c. 147, s.57-61,securi re Alt Tel.No.: ty work quires 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 t Owner/Agent al Signature Telephone No. I PERMIT FEE: $