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Home My WebLink AboutBLDE-21-001487 Commonwealth of Official Use Only 0Massachusetts Permit No. BLDE-21-001487 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:9/23/2020 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) 18 RANDOLPH RD Owner or Tenant GOMM NELSON R Telephone No. Owner's Address GOMM LAUREEN A, 18 RANDOLPH RD,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appr ' ' x) // Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 o.o 0 _ Z New Service Amps Volts Overhead 0 Undgrd 0 ,.0 o • s firfifierr Number of Feeders and Ampacity Jr) 40/1 , Location and Nature of Proposed Electrical Work: Wiring of hot tub. VVV O 'V?J Completion of the following table may be waived t i"rt.''.: • of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 1 • Transformers 4,, No.of Luminaire Outlets No.of Hot Tubs 1 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. 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 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 Data Wiring: Heaters Siens 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: (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: MATTHEW ABOODY Licensee: MATTHEW ABOODY Signature LIC.NO.: 22360 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:79 KINGSWEAR CIR, SOUTH DENNIS MA 02660 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 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 • / i4 Commonwealth _` adeac aueo& Official Use Only .� ,• *! ��]]� /`J Permit No. '1/4.i*el — •1/44_ 2epart`meni of ills Serviced Occupancy and Fee Checked . BOARD OF FIRE PREVENTION REGULATIONS [Rev. iro7) (leave blank) 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 7'YPE ALL INFORMATION) Date: V07-720 City or Town of: Y,4geit u lei p ('i 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) ( r /7 i9-,-,O,.X"-A fZ C) Owner or Tenant / Jsow 67.2 Len✓1 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 24, Amps at) / 2g(t Volts Overhead Undgrd❑ No.of Meters 1 New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: X70/' -til i) tit?iv75 Completion of the fol! table m be waived the I for of Wires. Total 'e' No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans °wrn�No. f TranoKVAsformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grad ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No. Initiatingon nDeteand Devices No.of Ranges No.of Air Cond. Ton No.of Alerting Devices Heat Pump Number. Tons_. KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 Municip 0 °� CyonneMion No.of Dryers Heating Appliances KW Security of Devices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices oruivalent 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 (7 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: /ff4 ( LIC.NO.:7Z2&?/( Licensee: /1 fd-tet- Arg Signatu >< 7 LIC.NO.•. 3(,r 4 (If applicable,enter"exempt"in the litense number line.) Bus.Tel.No.:7'?-VI 6 Q136 Address: ?9 0"tst1c ,�,,,' 6,d S. O.- ;,vii 4/4.. 02660 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. 1 PERMIT FEE:$