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Home My WebLink AboutBLDE-22-000012 Commonwealth of Official Use Only � Massachusetts Permit No. BLDE-22-000012 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:7/1/2021 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) 41 STANDISH WAY Owner or Tenant DUGAL MARTIN J Telephone No. Owner's Address DUGAL G M &M M, 823 E THIRD ST, BOSTON, MA 02127 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: 9?9999??999999?9 Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 7 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 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 3 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/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 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 perjuiy,that the information on this application is true and complete. FIRM NAME: ROBERT J CARLSON Licensee: Robert J Carlson Signature LIC.NO.: 16945 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:39 NAUSET RD,W YARMOUTH MA 026733752 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 )/Is(2, 161, 14 Consatonwoa&97 Maeaackuaslla ,Official Use Only �t c� c-� Permit No. G=—erZ,'CO 2 ,,s', 2e arimani ol.. irs Serviced 1 i Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (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) Date: City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned Ives notice of his or her in ntion to perform the electrical work described below. Location(Street&Number) �� s� 4,017. Owner or Tenant ./Yi'dcei/';;,,/ Ovcam- Telephone No.��Yf 9�S'>/� I Owner's Address 1� Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service ili0 Amps /2't/,L Y,Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters • ' Number of Feeders and Ampacity iLocation and Nature of Proposed Electrical Work: a. t Completion of thefollowingtable may be waived by the lector of Wires. W No.of Recessed Luminaires 7 No.of Ceil.-Susp.(Paddle)Fans No.oof Total Transformers KVA (2). No.of Luminaire Outlets No.of Hot Tubs Generators KVA kNo.of Luminaires Swimmin Pool Above In- No.of Emergency Lighting g Qrnd. ❑ grnd. ❑ Battery Units ;;.J No.of Receptacle Outlets 7 No.of Oil Burners FIRE ALARMS No.of Zones N- No.of Switches 3 No.of Gas Burners No.of Detection and Initiating Devices I U No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons _.KW No.of Self-Contained Totals: - '-— Detection/Alertin Devices Local 0 Monnecunicipltion ❑ other _ C 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 _ Wiring: No.Hydromassage Bathtubs No.of Motors Total HP • Tel communications 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: 7- / -1/ 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 pains and rnalties ofperjury,that the information on this application is true and completes/2 a.._ c FIRM NAME: C/9Gj/Ay,/ 6/ ,/ '-e- 2O/ LIC.NO.: /14 7 Licensee:adg7lY�t� i/c_, 1 Signature LIC.NO.:e • jj 9 (If applicable,enter"exempt' 'n the lic number line.) Bus.TeL No.' _ Address: 3 'j n..i'd?t Alt.TeL No.: 9 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. ��j OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally C-' 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:$