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Home My WebLink AboutBLDE-23-000515 tusiCommonwealth of Official Use Only /M ', Massachusetts Permit No. BIDE-23-000515 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:8/2/2022 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) 879 ROUTE 6A Owner or Tenant Joe Taurus Telephone No. Owner's Address 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 Air Conditioner. 4 i 4f,41/141°: � 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. 1 Ton l 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 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent 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: Licensee: Matthew Gordon Signature LIC.NO.: 55830 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:22 Station Avenue, South Yarmouth Ma 02664 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:$50.00 Q/2 7/74 W.(Pizoi -2 Cl ' w. 2--/-fit.) --R `CEIVED r AUG 0124 nn /�,�` �j t�Ommonwtatpt of///aeeachivalle �O�'fficciall Use Only BUILDING DE.) I J y T 2)4M �_ni /g Serviced Permit No. -�'-�] "CC J By A t"" '""' nj.t `'111,,/ BOARD OF FIRE PREVENTION REGULATIONS pa and Fee Checked may. lrol] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code MEC),527 CM et 2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: VI z'y.L' City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned ves notice ofhis orl3v,Intention to perform the electrical work described below. Location(Street&Number) '7 9 (7- . 6 f Owner or Tenant Jc c 1 to r 5 Telephone No. Owner's Address cot(v I 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❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: re w) rte3t he_ vt/ lirC—. 8 y Completion of the following.table may be waived by the Inspector of Wires. IA No.of Recessed Luminaires No.of CeIL-Soap.(Paddle)Fans No.of Total Transformers KVA nNo.of Luminaire Outlets No.of Hot Tubs Generators KVA tic' No.of Luminaires • Swimming Pool de ❑ grad. ❑ Battery unitscery Long "z:J No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices 1 led No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices lr No.of Waste Disposers Heat Pump Number KW. No.of Self-Contained Totals:I [Tons._._1 ._._._. Detection/Alertin&Devices No.of Dishwashers Space/Area HeatingKW Municipal Local❑ Connection ❑ ate• No.of Dryers Heating Appliances KW Security stems:l No.of Devices No.of War KW No.of No.of Data Wiring: or Equivalent Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring• No.of Devices or Equivalent OTHER: 6-6Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value f 1 cal Work: (When required by municipal policy.) Work to Start:6 /1/) z_ 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 (S ify:) I certify,under the pltins and of petjary,that the infer orlon on this application is true and complete FIRM NAME: �> d'� ti �� l�C-� C� 6 r �� LIC.NO.: �.J",�V Licensee:ivl etitiq t✓Vv apt r o V) Signature LIC.NO.: (If applicable, empt"in the lie number line.) Address: (7 V LDS-fe d.1 ,,ri i t Bus.Alt TeL No.: U�6 ��1�� *Per M.G.L.c. 147,s.57-61,se rkrequiresf Alt.Tel.No.: Department 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 signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Signature Telephone No. 1 PERMIT FEE:$ 67) -- I