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HomeMy WebLinkAboutBLDE-21-005576 Commonwealth of Official Use Only kLE.-��, �, Massachusetts Permit No. BLDE-21-005576 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:3/28/2021 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) 17 POINT OF ROCKS RD Owner or Tenant BISHOP RICHARD A Telephon Owner's Address 17 POINT OF ROCKS RD,YARMOUTH PORT, MA 02675-2077 ' Is this permit in conjunction with a building permit? Yes 0 No ❑ ��r,eck • • • • 4t• :ox) �f� Purpose of Building Utility Authorizati t,yj 0•tu. 4 It.... L•/ Existing Service Amps Volts Overhead 0 Undgrd ` b f 7 r,„' New Service Amps Volts Overhead 0 Undgrd 0 P•. if • w gar Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: In-ground soaking pool. a:146;PCompletion of the following table may be waived by thepector 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. 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 0 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 Siens 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: Brian Mcgrath Licensee: Brian Mcgrath Signature LIC.NO.: 11807 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 11 TURTLE COVE RD, EAST SANDWICH MA 025371710 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $85.00 akin 6 J, '/4( 4. //�� p0'� �///I Official Use Only C.ommoiuvealth o�///a96ac�e�3 Pt v, �t cc�� c�77 Permit No. -$7 , � e a .Jipartment ol}ire�ervice� c e Occupancy and Fee Checked n„..; BOARD OF FIRE PREVENTION REGULATIONS [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: 3 /, / City or Town of: rGt`H'/�Gl/7i. To the Inspe for°°°JJJ Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) /7 i/fi 1 0 I Poch' De/ Owner or Tenant 1/ a`-d 8i,,j'/I 0, �` Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes L"No ❑ (Check Appropriate Box) Purpose of Building 1Cf/de h ce Utility Authorization No. Existing Service Amps / Volts Overhead n Undgrd❑ 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: /) r�s 4, 4-04x y p� / 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 Above ❑ In- ❑ No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners 1 1FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons 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 ❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water Heaters 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. Estimated Value of Electrical Work: f©a f,O® (When required by municipal policy.) Work to Start: 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 cove e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. / FIRM NAME: �rifi, me G/•AA pie 4 /-/e/;04 LIC.NO.: /133 /3 Licensee: ,'r, /f7G 4re4 �1 Signature (If LIC,NO.: Licenseable,enter"exempt"in license number line.) 4/7 7/1` Address: Bus.Tel.No.:Lr� K y �j/ Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.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 ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $