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Home My WebLink AboutBLDE-22-003335 _ Commonwealth of Official Use Only t. Massachusetts Permit No. BLDE-22-003335 . 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:12/13/2021 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) 50 GROUSE LN Owner or Tenant Mark Haynes Telephone No. Owner's Address 50 GROUSE LN,WEST YARMOUTH, MA 02673 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 air handler, condenser, replacement panel, & upgrade grounding. 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 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 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 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: 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 f C -e(t RECEIVED '4,-,� e- -d' A. DEC 10 20k anh"/ iaas°Gh-uti5 Official Use Only _3 -�33.5 ' r ;1 I ar nl o`�ire Serviced Permit No. Z \ r :., J. II_DING DEPARTME T Occupancy and Fee Checked oi ,.�%�i fit ' ---:,a •-E•a-i. - --.�•�^ EVENTION REGULATIONS [Rev. 1/07) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 4, \I All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 27 CM 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /. 0 ,� Of - City or Town of: YARMOUTH To the Inspector of ires: •-1.: By this application the undersigned gives notice of his or her intention to perform the ctrical work described below. 1 Location(Street&Number) _SZ3 CS, (7,/Vy WAIN': 1/'_ - 3 y'...- -' Owner or Tenant i .1 f '{ c-fI%✓"et'_,/' Telephone No. sy c Owner's Address 4 \ Is this permit in conjunctionwith as uilding permit? Yes ❑ No (Check Appropriate Box) Purpose of Building ri/i,/e�L E-j,- � Utility Authorization No. Existing ServiceAy!1 Amps .>.Z 7/ ///Volts Overhead❑ Undgrd;S No.of Meters q New Service Amps / Volts r'j Overhead❑ Undgrd El No.of Meters r,,� Number of Feeders and Ampacity _ Z i r 1, j eopZoed , ate,., e�, f/ t Location and Nature of Proposed ectrical Work: ,� , ' -- */'j e.e , t 4, / 'Y / "vie""vie" • C�V it, i %Ly f ice L �` ✓ ,- ,‹ ` so Completion f the followin&table may be waived by the Inspector of Wires. C! No.of Recessed Luminaires No.of Ceil:Sosp.(Paddle)Fans No.of Total Transformers KVAry - '1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA i 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 t. Initiating Devices No.of Ranges No.of Air Cond. Tons 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❑ Municipal ❑ �� Connection 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 El ctrical Work: c2C}t2t (When required by municipal policy.) Work to Start: ..1 ' ,' Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO E 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Mb BOND ❑ OTHER 0 (Specify:) I certify,under the pains and pen lties of perj,,that the info a on on this application is true and complete. FIRM NAME: r..i .J l — mac_ LIC.NO.: / 9a Licensee: ! t'f-h Signature LIC.NO.y 'l/ (If applicable,enter'ex ,fit' in_the license nun:per lin i /l Bus.Tel.No.:______,.Address: 37 / , PiL1 j f�^ =7w"k-- 7i i'L �Y�'-e-J-vi f ji`I Alt.Tel.No.: r" y " *Per M.G.L.c. 147,s.57-61,securitiwork 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $