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Home My WebLink AboutBLDE-21-005650 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-005650 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:3/31/2021 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) 112 OLD MAIN ST Owner or Tenant Curtis Fleming Telephone No. Owner's Address 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: "Electrical renovations"(??) 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 0 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/Alertinc 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 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 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. 41D o�06 67 FIRM NAME: Francis X Mcpartlan ��CC Licensee: Francis X Mcpartlan Signature LIC.NO.: 17552 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 19 RIDGEWOOD ROAD,BOX 817,SOUTH ORLEANS MA 02662 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: $75.00 Po.tete 1.17421 (' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ,.,OF Y All work to be performed in ackordance with the Massachusetts Electrical Code, (MEG), 527 CMR 12.00 /..+ 49. _ (OFFICE USE ONLY) g _= TOWN OF YARMOUTH By _ MATTACHEESE Fee: $ PERMIT NO. C >`� ` �> P 90 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 3"—2q--202I To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. j� Location(Street&Number) (' t 20 '/ H'I kJ i Owner or Tenant 0-1 S 1 M I14i Telephone No. Owner's Address �/ Is this permit in conjunction with a building permit? L� Yes No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overheadfl Undgrd 1 No. of Meters New Service Amps / Volts OverheadL Undgrd 71 No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed electrical Work: l t-r --Trt1. o5 Completion of the following table may be waived by the Inspector of Wires No.of Total No. of Recessed Fixtures No. of Ceil.-Susp.(Paddle)Fans Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA Above In- rn No. of Emergency Lighting No. of Lighting Fixtures Swimming Pool grnd. grnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Detection and No. of Switches No. of Gas Burners Initiating Devices Total No. of Ranges No. of Air Cond. Tons No. of Alerting Devices Heat Pump I Number Tons KW No. of Self-Contained No. of Waste Disposers Totals: fl Detection/Alerting Devices Municipal No. of Dishwashers Space/Area Heating KW Local 0 Connection 11 Other Secutity Sic : No. of Dryers Heating Appliances KW No.of Devices or Equipvalent No.of Water No. of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No. Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may be issued 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 a permit issuing office. CHECK ONE: INSURANCE BOND[ OTHERJ (Specify:) (Expiration Date) Estimated Value of Electrical Wo1k: (When required by municipal policy.) Work to Start: 2) 30' ` Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify,under the iR4 and penalties ofperjury,that the information on this application is true and complete. FIRM NAM : I"� I"1�- (L eL-C4(7,0_ T/c___ er1 in LIC. NO. ' 1 Licensee: `•' , "l V kftf(,k>J Signaturerts t,,,�c,.g X, n V A J t�LIC. NO. 34- O (If applicable, enter"exempt"in the license numb r li a Bus. Tel. No.: �i O t 1-S 5- 3 b Address. Cl'1- 1L�IVi`t�- 00-L M 4 tY )9j Alt. Tel. No.: F>c).6 4 a0 0 4.41s 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.0 Owner/Agent Signature Telephone No. [Rev.04/00]