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Home My WebLink AboutBLDE-22-005440 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-005440 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:3/29/2022 City or Town of: YARMOUTH To the Inspector of 77Wires:V-268-2-98/7 By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 2 SEMINOLE DR 41)8-362-3?CS Owner or Tenant OLDHAM CAROL E Telephone No. Owner's Address 2 SEMINOLE DR,YARMOUTH PORT, MA 02675 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: Replacement heating system. Completion of the following table may be waived by the Inspector of fires. No.of Recessed Luminaires i No.of Total No.of Ceil:Susp.(Paddle)Fans 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 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices 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 ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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 1 (0/zv g/ CINE ccy i,/ qA (mato, 1\Yr4 'fly 6.-//e l RECEIVED k :'� MAR 2 8 2022 0 nwsatth ol r//aaearnuaalfe Official Use Only B' Pt cc77 Permit No �- r -; 1.- ' 1NG DEPART ME s artnun4 o/.. irs�arvicse = :a 'RD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK cAll work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 CM11 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1 Agri.'7-- ,s: City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her inAntion to perform the electrical work described below. ---"A Location(Street&Number) `S�j yyt O l ,/ Owner or Tenant (4 t 01 0/01 h A J� Telephone No. 7 7 1-/ 2 D 4' �--�� Owner's Address �t Is this permit in conjunction with a building permit? Yes ❑ No.. (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 k ' Number of Feeders and Ampacity I Location and Nature of Proposed Electrical Work: e-d W i i . 14--e.°1-1 /Pbt eWt lrj .0‘, Completion of the following'_table m be waived by the Invector of Wires. r!" No,of Recessed Luminaires No.of Ceil:Sos No.of Total ,,/ p.(Paddle)Fans Transformers KVA ,C.t No.of Luminaire Outlets No.of Hot Tubs Generators KVA A`- No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners y FIRE ALARMS INo.of Zones t. No.of Switches No.of Gas Burners "No.of Detection and t — - Initiating Devices 't No.of Ranges No.of Air Cond. ons[ No.of Alerting Devices No.of Waste Disposers Heat Pump I Number l Tons p KW 'No.of Self-Contained Totals: ......_...._... r Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW I, l❑ Municipal Connection ❑ Other 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: /l Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 0 V (When required by municipal policy.) Work to Start: -5454,2 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 BOND0 0 OTHER (Specify:) I certify,under the pains gnd penalties ofperjury,that Of information on this application is true and complete. FIRM NAME: km—Whew 61,.:',* o L eC-77-,.c- Licensee �r,�. Licensee. �„ LIC.NO.:�J g3y g • vi 1`'ta�' Gjor 0U Signature f-"� LIC.NO. (If applicable,enter"exempt"in the license number line.) Address: Bus.Tel.No.• c? �(]77 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: Lic.No.OWNER'S INSURANCE WAIVER: I am aware that the Licensee does trot have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one Owner/Agent owner ■ owner's a:ent. Signature Telephone No. PERMIT FEE:$