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Home My WebLink AboutBLDE-21-002803 Commonwealth of Official Use Only NI Permit No. BLDE-21-002803 • .Ems; Massachusetts 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:11/17/2020 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) 25 GINGERBREAD LN Owner or Tenant GALVIN PAUL GERARD Telephone No. Owner's Address 6004 kikAY o,i5 GINGERBREAD LN,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. • z Existing Service Amps Volts Overhead 0 Undgrd 0 New Service Amps Volts Overhead 0 Undgrd 0 .of 1 :��. s ��r Number of Feeders and Ampacity p Location and Nature of Proposed Electrical Work: Receptacle for fire place blower. B Completion of the following table may be we • ct49f o Wires. f No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of ` Transformers ,i A No.of Luminaire Outlets No.of Hot Tubs Generators No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 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 ❑ Municipal ❑ 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 perjury,that the information on this application is true and complete. FIRM NAME: A J Pulley Licensee: A J Pulley Signature LIC.NO.: 21843 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:289 QUAKER MEETING HOUSE,RD,E SANDWICH MA 025371366 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: $50.00 9. t ( lig( OKg/ • Official Use Only ontmonwea o as�ac etfa _ 7 Y� It— III{_f/ cc�� cc77 Permit No. — 431 Q ��—.c 21 epartment o/..tire�erviced -' , y BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked �,,,, [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: t t/r to/i-0 City or Town of: t ,q-et,µ,, ,rti 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) 2 c 0„vG,r-�,Z Ri i ) L -7.).f VA-a '34.r. 4. Owner or Tenant tM4;z,./ C?, t,y,n,, Telephone No. .y Owner's Address M Is this J permit in conjunction with a building g permit? Yes ❑ No Er (Check Appropriate Box) Purpose of Building 1e-,i',r:x.)L,, Utility Authorization No. J V l Existing Service Amps / Volts Overhead ❑ Undgrd 0 No.of Meters `, New Service Amps / Volts Overhead n Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 12rZr r/K er' 1,,, i;/lt=f.1i cc- rrz, 2 Lz.9S ,,,sew r Completion of the followingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No. f 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 0 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 AlertingDevices 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❑ Municipal ❑ Other Connection v No.of Dryers No Heating Appliances KW Security Systems f Devices or Equivalent No.of WHeaters ater 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: Attach additional detail if desired,or as required by the Inspector of Wires. Z Estimated Value of Electrical Work: (When required by municipal policy.) tWork to Start: t I /r te/24:). 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 covers a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE (E BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on th' application is true and complete. FIRM NAME: }.4 4 vLL7i Li ; I Z ?r2I LIC.NO.: Licensee: 4.3 . ilc,1.4 Signature LIC.NO.: 4 Z>y'y 3 (If applicable,enter "exempt"in tile license number line.) Address: U3S Roc rE-)?(-I Sex'r l4 j�„5 Bus.Tel.No.:S tr.?S't'3,131 `Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.LT c.No.. 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 Signature Telephone No. I PERMIT FEE: $ l