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HomeMy WebLinkAboutBLDE-22-004470 Commonwealth of Official Use Only T' . Permit No. BLDE-22-004470 ,,� Massachusetts 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:2/10/2022 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) 68 WINDJAMMER LN Owner or Tenant MCPARTLAN PATRICK A Telephone No. Owner's Address MCPARTLAN ELLEN A,68 WINDJAMMER LN, SOUTH YARMOUTH, MA 02664 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: Replacement boiler 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 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. To No.of Alerting Devices 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 0 Municipal ❑ 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 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: Gary L Gordon Licensee: Gary L Gordon Signature LIC.NO.: 15290 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:37 BILLINGSGATE DR, DENNIS MA 026382234 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:$50.00 6-4. / 1f2 'c keefdt __ ;6( ! RECEIVED FEB10 20 oaff �k ammo aa[Ut o` aedac�iudalfdPt Officialfici Use Only \�v _;It`- N T Permit No. .. :"GILDING DEPART�gry� ` �'J �7 \l '!�.», fi - -- �!J_f__Rr ni o/. L Sun icfd 4"\( ,};f I `?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(M ),527 CM 12.00 ` (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: © �— City or Town of: YARMOUTH To the Inspe for of W res: By this application the undersigned gives not' a of his or her' tention to perform the elect ical work descri to Location(Street&Numbbeer) '` Owner or Tenant j�l pt(- jet i•' _ Telephone N 7 �g i Owner's Address ' e.4,v� (� Is this permit in conjunction lath a b ding permit? Yes ❑ No , (Check Appropriat x Purpose of Building Utility Authorization No. Existing Service/aG Amps /? /al Volts Overhead 1A.. Undgrd❑New Service Amps No.of Meters / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampactty (Al _ p C �.-r - �0 ;1k,z___Location and Nature of Proposed Electrical Work: iu Completion of the following,table meg be waived by the Ins ector of Wires. �1f No.of Recessed Luminaires No.of Cell:Sosp.(Paddle)Fans No.of Total Transformers KVA 1:-:.-1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA KZ\ t. No.of Luminaires Swimmin pool Above In- �No.of Emergency Lighting g grad. ❑ grad. ❑ Battery Units _ `` No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners -No.of Detection and Initiating Devices t No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number'Tons 1 KW No.of Self-Contained ' Totals: _Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local Mcial ❑ Couninnectiopn 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of 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 E ectric Work: c2.g, .< (When required by municipal policy.) Work to Start: O 21nspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE GE: 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 cove ,ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE !i BOND 0 OTHER 0 (Specify:) I certify,under the pains and',trifles of perjury,that the i or ad non this application is true and complete. FIRM NAME: G �NL 5 Qv s' ��I^� LIC.NO.:complete. fa Licensee:__ (L ,,C/4 4,,--,. Signature `/" LIC.NO.:g f�c Ael applicable,enter"exe ;' ,ln the license numb line.) Addr Address: 3� r tie_ Bus.Tel.No.: ?� *Per M.G. c. 147,s.57-61,se¢Lrr ork requires Department of P lic Safety"S"License: Alt.Lic.No. f L. " OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance c erage 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. I PERMIT FEE:$ I