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HomeMy WebLinkAboutBLDE-21-006819 406\ Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-006819 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:5/24/2021 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) 10 GLENWOOD ST Owner or Tenant PETERSON JANICE M TRS Telephone No. Owner's Address PETERSON RICHARD E TRS, 10 GLENWOOD ST,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropi ) dlliP Purpose of Building Utility Authorization No. i Existing Service Amps Volts Overhead 0 Undgrd D e �J � New Service Amps Volts Overhead 0 Undgrd 0 q 4V GrimI . Number of Feeders and Ampacity O ` , �, Location and Nature of Proposed Electrical Work: Air handler&boiler. © // Completion of the following table may be waived by t I • • • Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle) No.of 4 Fans Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool grog e ❑ grnd. ❑ No.of Emergency Lighting ery 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 Initiating Devices No.of Air Cond. 1 Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices al Munici No.of Dishwashers Space/Area Heating KW Local ❑ Connection ❑ Other: HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. required bymunicipal policy.) Estimated Value of Electrical Work: (Whenq p P y' 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 ❑ 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: GARY L GORDON LIC.NO.: 15290 Licensee: Gary L Gordon Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:37 BILLINGSGATE DR, DENNIS MA 026382234 *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 I PERMIT FEE: $50.00 I Signature Telephone No. Oktgrika 0461) iali PE4572a17 Alb ft'- ,_ )(1 -,, �St` 434 �- ar+a+irh4s 47'!� Usc m&WOO Permit No. ' - 1.9 BOARDand F OF FIRE PREVENTION REGULATIONS b�-•• t'PLtCATIbN OR= .-AP RMR TO PEfp RFORM t _ All work to be performed in ate, with the M Code iC,aL WORK ('LE APR(NT IN INK OR TYPE ALL INFO.RWITT019 Date: 527 tzoo f r City or Town of YARMOUTH By application the givesnotice otitis or her' To the Wires: _ intention to • electrical work desGnbai below. Location(Street&Number) 1>7. WOO/Owner or resat `\Gi 0i j C� F �Cftn•J -- Owner's Address '�� Telephone No. Is tids permitiR eo ,,, ..r,): with a , 41 +, . permit? Yes 0 ty / r (Check Appropriate Box)Purpose of Building / f Existing Servic944 Amps l / trite Overbead 1=t I Uadgrd❑ No.of Meters New Service Amps / V Overhead 0 Number of Feeders and Ampadty Usdprd 0 " No.of Helots Location and Nature of Proposed Electrical Work sw Not of au to be waived die WhetNo.ofC .(Paddle)Fansr randonnets No.of Lnmiaa$e Oatte[a No.of Hot Tabs KYA VNa of Swhiuniag Pool ❑ ❑ moors KVA ILNo:of Receptacle Oaf No.of Oil Burners DohsNe,of Switches FIRE of Zones No.of Gas Burgers o. Initiating i. No.of Ranges No.of Air Coal, Tam Devices- � Tans ,No,ofAla Alerting Devices .. No.of Waste Disposers I KW No.of I Number Irons Sei Co No.of Dishwashers D�tvioa Space/Area Resting KW �Loc i❑ ❑ i Other No.of Dryers Heating Appliances KW Security p ; No.of Wager , No.of No.of Na of eV ulcer or Bqufv:imt rV Heaters Sins Ballasts barer Wiring: No.Hydrt►Heaters No.of Devices or Equivalent . Bathtubs No.of Motors Total HP `T�mmunications Whin OTHER: _ Na of Devices or - Estimated Value ofjiiiiir�, Wor1G(- ' (When�ed by l policy. `net or as reqired by the Inspector ojMoes. Work to Start '- Inspections to be requested in accordance with MEC Rule 10,and upon won. C) INSURANCE I G : Unless waivedby the owner,no permit for the performance the licensee provides proof of liability insurance including"completed of isel substantial work may issue Th ess m> Signed drat such coverage is force,and bus exhibitedor equivalent. The C1 ONE: f of same to the permit issuing office. I attder theE�p�� es� ❑ OZTiER ❑ (Spepfp:) ,irpe4my,that the information on this application Zr true and com ./ FIRM NAME: "p R,QO/t kit QJ,&4 gl#i./4 G c_- LICC.NO. l aZ rQ . Licensee ,...0S:fili ed, Signature . --** ".".""..---- Lie NO.: (if applicable. r rAVAZ✓Je f9"t r� fire? At TeL NNo a;__' _Qo_f_ !�/Add 3 �gy J *Per M.G.I.C. 147,s.57-61,ma yrequires Department of Public SafeyS"license: Lic.No. - - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hove the liability insurance co normally "---�— __tt required cal. By my signature below,I hereby waive this requirementI am the(check one)❑owner 0 owner's agent i� Signature - ?Telephone No. PTsA1urT ran_ - ' • o1"'117 TOWN OF YARMOUTH - �rQ BUILDING DEPARTMENT o . . y 1146 Route 28, South Yarmouth, MA 02664 `c" "= , .o�sE 508-398-2231 ext. 1263 Fax 508-398-0836 K. Elliott, Inspector of Wires kelliott(a,varmouth.ma.us May 26, 2021 Gary Gordon 37 Billingsgate Drive Dennis, MA 02638-2234 Location: 10 Glenwood Street, West Yarmouth Permit Number: BLDE-21-006819 Dear Gary, The above noted location inspection failed to pass for the reason(s) listed. Article 210-63 (A) Receptacle required within 25 feet. Please forward the required re-inspection fee of eighty dollars ($80.00) to this office and advise when the corrections have been made and when access may be gained, to the property, for the re-inspection. If you have any questions please do not hesitate to contact me. Sincerely, Town of Yarmouth, Building Department K. Elliott, Inspector of Wires