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Home My WebLink AboutBLDE-22-006456 -- Commonwealth of Official Use Only - Massachusetts Permit No. BLDE-22-006456 � ( 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:5/10/2022 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) 108 BRAY FARM RD NORTH Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463 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: Install UFER 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 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/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: Michael J Totten Licensee: Michael J Totten Signature LIC.NO.: 14044 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:228 STONEY CLIFF RD, CENTERVILLE MA 02632 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: $0.00 SOLc__j;;- I ea-6E)uTi (a..\-?jE) CO i I i1/41-c •( 1 4 727, RECEIED �f t�j 7-7_ Commonwsa[th o�///aedae�iudelfd Official Use Only MAY 0;�� Serviced Permit No. r Z2- (0(4 S CO li-T �,,,,,.. F sparimeni o ire } I Occupancy and Fee Checked BUILDING UE � ,.'' NT :.OARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) ATION 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: RI 6 zo ZZ 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) (p'B 2:)C-Q� -�,ptc-y•• N . Owner or Tenant pW t" 'ID-PC- \ (CAM nc Telephone No. IOwner's Address 1 I Is this permit in con junction with a building permit? Yes No El` (Check Appropriate Box) Purpose of Building�e Noal-,tp KS-kcc'0-0-\ :;.(AAA q• Utility Authorization No. Existing Service Amps / Volts Overheaii❑ Undgrd C No.of Meters New Service ZOO Amps \ D /Z4 p Volts Overhead❑ Undgrd [No.of Meters i 1 Number of Feeders and Ampacity Location an Nature of Proposed Electrical Work 5 (` m t�(•) (k F c_e_ (2-3CouI -Q0; kg ju Completion of the followinKtable m be waived by the Inspector of Wires. T',t7t �l No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.o 'i T' Transformers KVA 'Z No.of Luminaire Outlets No.of Hot Tubs Generators KVA <t No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting _ �rnd. grnd. ❑ Battery Units No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS INo.of Zones --. No.of Switches No.of Gas Burners No.of Detection and it — Initiating Devices No.of Ranges No.of Air Cond. Tons! No.of Alerting Devices 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❑ Municipal ❑ Other• No.of Dryers Heating Appliances KW Security Systems:*on No.of Water No.of Devices or Equivalent _ No.of No.of Heaters KW Signs Ballasts DatNo.of Da evices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: C No.of Devices or Equivalent ) OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. M Estimated Value f ElElectrical Work: $�O. v I (When required by municipal policy.) Work to Start: U 6 2.-.07,7— Inspections to be requested in accordance with MEC Rule 10,and upon completion. <3 INSURANCE OV RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless CSC) 6 the licensee provides proof of liability ins ce including"completed operation"coverage or its substantial equivalent. The (� N undersigned certifies that such cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I� fY) I certify,under the pains Ind pen lties o erjury,that the information on this application is true and complete. 10 1.1 ...4 FIRM NAME: i cA.N 2C. C LIC.NO.:( Qt-kk Licensee: Signature LIC.NO.:ZLS iC)- c4) ---.Q (If applicable,enter"exe t"in the license nut litre Bus.Tel.No.• S-J� '� 'T Address: _Z2-€S vkP,c/ ()( . �,� (,U t11 64- Alt. Z *Per M.G.L.c. 147,s.57-61,sec ity work requires Department of Public Sa ety�S"License: Lic.No. t OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement, I am the(check one)❑owner ❑owner's agent. Owner/Agent I Signature Telephone No. I PERMIT FEE:$