The URL can be used to link to this page

Home My WebLink AboutBLDE-21-002806 Commonwealth of Official Use Only 4-1101 Massachusetts Permit No. BLDE-21-002806 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 perform the electrical work described below. Location(Street&Number) 340 HIGGINS CROWELL RD 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 ❑ No ❑ (Check Awyritte Box) se 02; 4/4/0 2 Purpose of Building Utility Authorization No . '23441432 Existing Service Amps Volts Overhead ❑ Undgrd 0 NAL or Miters New Service 200 Amps Volts Overhead 0 Undgrd El No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 200 Amp underground service. (GANNON TRANING CENTER) 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 :Pia! 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/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 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: John C Burke Licensee: John C Burke Signature LIC.NO.: 50364 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:45 DIX ROAD EXT,WOBURN MA 018016104 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: $0.00 & ? lit(etZa 1 t v1tbA • /. ttiI4 •Al , I Conunonwsanh�Ufa a�cueette Official Use Only i• p i i 2spartnunE el glee Serviced No. (��i1 ZW)(7 neaveBOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked blank Rev. 1/071 '--- APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) (M C),527 CMR 12.00 � City or Town of: Date: 1 By this application or the undersigned gives noticeYARMOUTH or her ration toTo the Insp ctor 'Wires.: Location(Street&Number) `� performthe electrical work described below. Owner or Tenant / ®rJr}i / Owner's Address . Telephone No. Is this permit in conjunction with a building Per t? Yes No ❑ (Check Appropriate ) 1 � Purpose of Building ,Q ppro riate Box S a�pn jQ ` JtUtility Authorization No. Y� Existing Service Ampse .. /1, 2 / Volts Overhead❑ Uudgrd❑ No.of Meters l �c ..g00 Amps .To / d Volts Overhead❑ Uudgrd la ' Number of Feeders and Ampaclty Its No.of Meters Location and Nature of Proposed Electrical Work: ll! Com,tenon o the ollowin: table m. be waived b the I ector o Wires. (Z.': .of Recessed Luminaires No.of Cell.-Sasp.(Paddle) `o.o Fans ota No No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA 4 No.of Luminaires Swimming Pool , II! n- 'o.o mergency g .ng ;NNo.of Receptacle Outlets ❑ d• ❑ Butte Units ..t• No.of Oil Burners ri No.of Switches No.of Zones No.of Gas Burners `o.o t etec ton an• _ 11,1 No.of Ranges Initiatin, Devices No.of Air Cond. °� No.of Waste Disposers 'eat ump um er a s ns No.of Alerting Devices Totals: " o.o e - out n • No.of Dishwashers Detechon/Alertin Devices Space/Area Heating KW Local❑ 'un cap No.of Dryers HeatingAppliances Connection 0 „ PP Key cunty ystems: o.o Heaters KW o.o o o No.of Devices or E,uivalent Si L •s Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Devices or E•uivalent No.of Motors Total HP • a ecommu• ca, •ns " ,gg: OTHER: .No.of Devices or E,nil/dent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of E ectrical Work:ja Work to Start: (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C YE 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 (S I certify,under the pains and penalties o e . pacify:) FIRM untie: fP r!►try,that the information on this application is true and complete. Licensee: OHAl (/12 LIC.NO.: (If applicable.enter"exempt"in the license number line. Signature LIC.NO.: Address: so t P Bus.TeL No.• _*Per M.G.L.c. 14 ,s.57-61,security work Alt.TeL No.: 7 .��CJ�� "S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am requires estha t ens f does not have the liability insurance coverage n�— reguired by law. By my signature below,I hereby waive this requirement I am the(check one II owner • owner's a:ent. Signature Agent g rtnally Telephone No. PERMIT FEE:$ .tee , SPIX6`)'j 1) r Imo' q- i) 46 ' 7p . 70 4)%ch, Npr4,2 /04r i 4/_ 3-7 * .