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Home My WebLink AboutBLDE-23-001330 w Commonwealth of Official Use Only wi` Massachusetts Permit No. BLDE-23-001330 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:9/13/2022 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 bel Location(Street&Number) 4 OAK GLEN VILLAGE G - Y7 5—• 924 8 Owner or Tenant GALLAGHER MARLIS C TR Telephone No. Owner's Address THE GALLAGHER TRUST,4 OAK GLEN VILLAGE,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 furnace. 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 1 No.of Detection and Initiatipe 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 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 Siens 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: ANDREW M LEVESQUE Licensee: Andrew M Levesque Signature LIC.NO.: 17318 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:461 LOWER COUNTY RD, HARWICH PORT MA 026461831 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. I PERMIT FEE:$50.00 a,.— �-a, RECEIVED 4' Commonwealth.o/Mamachissaiks Official Use Only • SE 1 � � �� Permit No. 23 — I /O ane and Fee Checked BUILDING D E f T :CARD OF FIRE PREVENTION REGULATIONS [Reeve 07]y (leave blank) ' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:co aoy2--. City or Town of: eykRJj4 1Jrl4-4- To the Inspe for of Wires: 8 By this application the undersign gives notice of his or her intention to perform the electrical work described below. y Location(Street&Number) if OAK &L- 4 VARYRO-u 7+ pOKT Owner or Tenant &A-1/(4--&4-MK Telephone No. U4 Owner's Address S Is this permit in conjunction with a building permit? Yes 0 No N. (Check Appropriate Box) -5 Purpose of Building 1WN 1€ Utility Authorization No. a Existing Service 1 Amps 120/2f0Yoits Overhead 0 Undgrd 0 No.of Meters ,CS J"iew Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: v'J j KA N(7 or K ri r QNkce Completion of thefollowin&table ntv be waived by the/ or of Wires. `: No.of Recessed Luminaires No.of CeiL-Snap.(Paddle)Fans T Total0V. Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. Li Battery Units 1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 1' No.of Switches No.of Gas Burners No.of Detection and Initiating Devices I ` No.of Ranges No.of Air Cond. TOE No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons KW _ 'No.of Self-Contained Totals:_ _ Detectlon/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 Muntcfp ❑ Other Cyonaectfon No.of Dryers Heating Appliances KW Security Devices or Equivalent No.of Water No.of No.of Heaters KW Sys Ballasts Data No.of fineDevices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications WI�rffang� Na of Devices or Egulva7ent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of El 'cal Work: 560 — (When required by municipal policy.) Work to Start.et 4?- Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE Cq))VE GE: 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 notation on this application is true and complete. Z FIRM NAME: 1 LIC.NO.: I I 9 t- Licensee: 0 , Signature LIC.NO.:J�� <—�, (If applicab , ter 'ex jathe li ruse r ape Bus.Tel.No.;. 3 J 1 Address: ( 11 K 7 AIL Tel.No.: *Per M.G.L.c. 147,s.57-e l,security work requires of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my s' bel27L7eTe1epone hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/Agent Signature 46'OR'.�3a1s`� PERMIT FEE:$50 � No.