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Home My WebLink AboutBLDE-20-006420 4" Commonwealth of "official Use Only I. 4*i Massachusetts Permit No. BLDE-20-006420 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:6/29/2020 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 42 MID-TECH DR Owner or Tenant RUHAN THOMAS J Telephone No. Owner's Address 344 JOHN L DIETSCH BLVD #4,ATTLEBORO FALLS, MA 02763-1073 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check App obi till,. tox) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 E►, w New Service Amps Volts Overhead 0 Undgrd 0 111nIi emmm Number of Feeders and Ampacity P Location and Nature of Proposed Electrical Work: Wiring for battery shed with 80 amp circuit. to Completion of the following table may be waive y the - ,,,,Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 7 /6/Tota Transformers No.of Luminaire Outlets No.of Hot Tubs Generators A 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 Tons 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 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: Tony A Molina Licensee: Tony A Molina Signature LIC.NO.: 12972 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:42 Lincoln St, Hudson MA 017491610 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: $100.00 4--e- 21)CrAND Ul t . 741 (PEA- Pc i 'A-ivri A-t_ C`t,00-c_ 9l31/7--,.. -- 7 C Er ,1 , JUN 252026 ! 14 Commonwealth el a Nmc r�4 --3 I Official Use On , [ �- �a r i (..'"::'U, (V 4 2.0 . o., • ./ Per No. c� cc--�� __ � t ti ' 2 epar6neent oj'}b+r-J�l�icas —_. 0 Occupancy and Fee Checked vk- \ = ; BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (lave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFOR TION) Date: 6-,23 "2"� �' City or Town of: YOn t.o To the Inspector of i/' s By this application the undersigned gives notice of his . her in ti°a,\to perform the electrical w. • k, lbw., 1 a Location(Street d:Number) ri edl v % '1---L`.-- + Owner or Tenant Gzt a L y -Q— A ESI C Te p, .ne r•� 1 y ?o J Owner's Address Qui"-.... Is this permit in conjunction with a building permit? Yes El No (Ch- . o.r E`dli )Y--. , Purpose of Building Utility Authorization No. �n I Existing Service Amps / Volts Overhead 0 Uudgrd 0 No.of Meters vNew Service Amps / Volts Overhead❑ Undgrd ElNo.of Meters R.Z • Number of Feeder and Ampadty Location and Nature of Proposed Electrical Work: W.i 4. A�) p(-kri y 411:110/(! (til vl Completion of the followin&tabic mg be waived by the Inspector of Wires. tal L� No.of Recessed Luminaires No.of Cefl"$O�•(Paddle) Traannsformer KVA . Fans Tof ( No.of Luminaire Outlets No.of Hot Tubs Generators KVA n • No.of Luminaires Swimmin Pool Above ❑ In- ❑ IVO.or Emergency Lightingg grnd. Krnd. Battery Units 'i No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones • No.of Switches No.of Gas Burners 'No.Initlatingo°Dcteand IuDevices II' No.of RangesNo.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tops . KW... No.of Self-Contained Totals: Number_ Tphs __ _.__ -. Detection/Alerting,Devlces No.of Dishwashers Space/Area Heating KW Local 0 Connection 0 Ome<, No.of Dryers Heating Appliances KWNo .ofDevices or Equivalent No.of WaterKW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent _ No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNofor Whin. No.of Devices or Equivalent _ OTHER: �l y 0 0 O Attach additional detail tf desired or as required by the Inspector of Wires. Estimated Value of Electrical Work:fil i (When required by municipal policy.) Work to Start: 6-4.2 y 2.0 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 0 BOND 0 OTHER 0 (Specify:) I certify,under the !ns and penalties cry,that the information on this application I true and complete. FIRM NAME: ) of( 3 N A 6 �-e CID,-c__ ,. ( k- LIC.NO.: f6 SU' 6 4 Licensee: -Tirl/1 7 M 0 Lend Signature �� LIC.NO.:/255 2— a Of applicable.enter"exempt"in the license number ling t7'0 n U 7n Bus.TeL No.: 1 'f�g►o3 Act 33 Address: Fe C�r,---,iJ i--- '(t v Q i 0/7 T 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. PERMIT FEE:S