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Home My WebLink AboutBLDE-22-006158 Commonwealth of Official Use Only • gt• ; Massachusetts Permit No. BLDE-22-006158 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:4/26/2022 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) 162 OLD MAIN ST Owner or Tenant Carla Sharrow Telephone No. Owner's Address 162 OLD MAIN ST, SOUTH YARMOUTH, MA 02664-4524 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: Three Split A/C units with attic air handler. 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 Initiating Devices No.of Ranges No.of Air Cond. 3 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 Ballasts Data Wiring: Heaters Signs 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: Licensee: Matthew Gordon Signature LIC.NO.: 55830 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:22 Station Avenue,South Yarmouth Ma 02664 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 ,IR-E' FIVE ® rAPR 25 2044 Commonwealth oi Maadachuea(fe Official Use Only BUILDING v E P'� �y f/ �Us/vcu t~insnf o C97 ��77 Permit No. e�-19(CO BY.--- -----'''..V 'i._. .* `JIAt Serviced +`` BOARD OF FIRE PREVENTION REGULATIONS [ e .Occupancy/ 7and Fee Checked) „ (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical (MEC),j.,27 CMR 00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7-2. City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned Oyes noti,S4 Qf is or her intention to perform the electrical work described below. Location(Street&Number) / 2 V t ' C ma,ill .5"T .57.),A-rt, 0 ( I'►''3tiA� Owner or Tenant Cr q�' C (ryq �0.�! Telephone No. ) = j iz(� 3� r Owner's Address Is this permit in conjunction with a building permit? Yes ❑ Np (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty f I Location d Nature of Proposed Elect cal Work: ) f r` /1 G ; a E w o K c�,nii�fi5 �-� 7�-;c. Air In�,, I e r Completion of the m be waived by the Invector of Wires. ,iv ay sp it. No.of Recessed Luminaires No.of Cell.-Sas No.of 'Total U. p.(Paddle)Fans Transformers KVA -:.t No.of Luminaire Outlets No.of Hot Tubs Generators KVA r;\ No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting 4grad. grnd. ❑ 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 Ili — Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump ber lTons J� VT K -No.of Self-Contained Totals:I Num "1 L Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* KV No.of Devices or Equivalent No.of Water No.of Heaters ' 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: r Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lectrical ork: l // ,l�� 7' (When required by municipal policy.) Work to Start:? / Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: 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 ❑ (Specify:) I certify,under the ,alas and'en•1 ol'pernu ,that he infor anon on this application is true and complete. FIRM NAME: s" �. lk LIC.NO.: e °— �f Licensee: fj1/701 e iv �n Y v ),1 Signature /' (If applicable, "exe �p e 1f'a nu er line.) �--- LIC.NO.:_ Address: (G15>)l " - j 9 4 — Bus.Tel.No.t�i c,'7 j C� 7 *Per M.G.L.c. 147,s.57-61,securi�ork requires Department of Public g�afe "S"Lic Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coveragenormally — required by law. By my signature below,I hereby waive this requirement. I am the(check one ■ owner • owner's a,ent. Owner/Agent Signature Telephone No. PERMIT FEE:$