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Home My WebLink AboutBLDE-22-000451 Commonwealth of Official Use Only •E` !'�i Massachusetts Permit No. BLDE-22-000451 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:7/23/2021 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) 40 MCGEE ST Owner or Tenant Clifton Mayfield Telephone No. Owner's Address 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 ❑ Undgrd 0 gNo.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 of mini split&service receptacle. 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 Abovernd. ❑ g rnd. ❑ No.of Emergency Lighting Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches 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 I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent 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: OTHER: No.of Devices or Equivalent 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 I certify,under the pains and penalties operjury,that the information on this application is true and complete. FIRM NAME: THOMAS J MADDEN Licensee: Thomas J Madden Signature Tel. NO.: 14065 (If applicable,enter"exempt"in the license number line.) BusAddress:39 MARINERS LN,PO BOX 291,YARMOUTHPORT MA 026750291 Alt. Tel. o..: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. ( /24( PERMIT FEE:$50.00 RECEIVED q JUL 23 2021 • t tN G D E PA RTM E �n17O�`u'°a v` //aeaacRua°[fe Official Use Only 2•°1oartmsnf o�.}ire Serviced Permit No, GZZ—CDl{ j BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked _ Rev. 1/07], k 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 TYPE ALL INFORMATION) ,. To theIopvire : I City or Town of: vno Date: By this application the undersigned giv s noRMhOorUTHention to perform the electriccal work described Location(Street&Number) r /r/� — e below. Owner or Tenant t c �w l Owner's Address ��rr / 1 e Telephone No. 4',3633 • are frerir.[ , e S- tr ee f 0' eAi Is this permit in conjunction w h a building permit? Yes r ti lie '2 f5- 1 Purpose of Building e No Lk (Check Appropriate Box) Utility Authorization No. IExisting Service Amps /: / Volts Overhead❑ Undgrd❑ No.off Meters New rvice Amps / __________Volts Overhead❑ Undgrd ❑ No,oeters 1 Number of Feeders and Ampacity w I Location and N:tore of Proposed Electrical Work: /,(1///%44 0 (f)//42 la-Migraiffinri id— th, Come letion o the ollowin:table m be waived b the Ins.ector o Wires. e No.of Recessed Luminaires No.of Ceil.-Sasp.(Paddle)Fans 'o•o ota "�'t No.of Luminaire Outlets Transformers KVA r,� No.of Hot Tubs �:` No.of Luminaires Generators KVA Swimming Pool ,r'od.e ❑ n- 'o.o mergency g ng No.of Receptacle Outlets nd ❑ Butte Units g No.of Oil Burners FIRE ALARMS No.of Zones v, No.of Switches No.of Gas Burners `o.o i etec on an 1 r No.of Ranges Initiatin Devices No.of Air Cond. 1 ota Tons No.of Alerting Devices 'eat 'ump `um er. o " `o.o e - onta nee No.of Waste Disposers Totals: ns No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW 'un ci No.of Dryers Heating Appliances Local❑ Connec tion 0 "her `o.o "a er KW ecu ty ystems: Heaters KW `o.o .o o No.of Devices or E.Divalent Si ns Ballasts Data Wiring: No.Aydromassage BathtubsNo.of Devices or E;Divalent No.of Motors Total HP a ecommun ca s ons r. r i g: OTHER: No.of Devices or E.Divalent I% Estimated Value of ectr' al Work; v Attach additional detail if desired,or as required by the Inspector of Wires. Work to Start: 7 �/ `� (When required by municipal policy.) SURANCE C VE �/ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INGE: Unless waived by the owner,no the licensee provides proof of liability insurance including „ permit for the performance of electrical work may issueent. unless undersigned certifies that such c,_o,v.,e�rs is in force,and has exhibited proof of same to the permit issuing office, `completed operation coverage or its substantial equivalent. The CHECK ONE: INSURANCE E - BOND I certify,under the pain an El OTHER 0 (Specify:)f[ Wallies of erJu/ry,that le informah!on on this app[[Cation is true and complete. FIRM NAME: /14 Licensee:� G C Signatur LIC.NO.: `_ ��,— (If applicable,e r"exe t"in the LIC.NO.: =�� Address: ny�nb line.) *Per M.G.L.c. 147,s.57-61,security work mitt' h o`16 Bus.Tel No.• — 7 OWNER'S INSURANCE WAIVER; I s Department of Public Safe Alt.Tel.No.: / Safety"S"License: Lic.No. aware that the Licensee does not have the liability insurance coverage normally required law. By my signature below,I hereby waive this requirement. I am the(check one wnrrd Agg ent Signature / owner � owner's a,ent. O Telephone No. PERMIT FEE:$