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Home My WebLink AboutBLDE-22-001726 Commonwealth of Official Use Only filtiMassachusetts Permit No. BLDE-22-001726 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:9/27/2021 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) 491 NORTH DENNIS RD Owner or Tenant JASON ROBERT A Telephone No. Owner's Address JASON JULIE L,491 N DENNIS RD,YARMOUTH PORT, MA 02675-2144 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 boiler. 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 g bovend. ❑ g rnd. ❑ No.of Emergency Lighting r Battery 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 Initiatine 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 Water No.of Devices or Equivalent KW No.of No.of Ballasts Data Wiring: Heaters Signs 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: Kung-Po Tang Licensee: Kung-Po Tang Signature LIC.NO.: 21928 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:518 COTUIT RD, MASHPEE MA 026492351 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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. I PERMIT FEE: $50.00 I G-e� a 10/5/ , b U `r Comononu'aalg.a Mamac'humds Official Use Only U0 " ( �� tit __- ' c� : '. �C.lspartms /`� S Permit No. i .v O i11t frVlCtd '" 1;W Occupancy and Fee Checked ,',,:' BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07] (leave blank) '31 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 INFORMA77ON) Date: Cj Z cL—Z City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned Iv�es 6 'ce of his her' on toVe_47 orm the electrical rk escribed(below.Location(Street&Number) T !( i 6� � rz `7t /d.`i Owner or Tenant s 5 p,� /"r' / /(�{ T 1 Owner's Address Telephone No. Sa8 3�3 c _1 Is this permit in conjunc n with a b ngpermit� Yes ,q� Purpose of Building �� 1-�� ❑ No � (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters li New Service Amps / Volts Overhead Number of Feeders and Ampadty 0 Undgrd❑ No.of Meters \ Location and Nature of Proposed Electrical Work: LerE-w--� r Lit Completion of the followinKtable mf be waived by the I�Inspector of Wires. rvi No.of Recessed Luminaires No.of Ceti.-Soap.(Paddle)Fans No.of Total No.of Luminahe OutletsTransformers KVA No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting nd. d. ❑ Bette Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.o etec on an 111 No.of Ranges Initiatin Devices No.of Air Cond. °ta Tons No,of Alerting Devices No.of Waste Disposers Totals:eatPump um er ons.... .._.. -...._............._...._. o.o e on n No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW Local❑ un p No.of Dryers Connection 0 OthertY Heating Appliances KW n ty yystents: o.o a Water o.o No.of Devices or E uivalent Heaters ' °•° Data Wiring: S s Ballasts No.of Devices or trivalent No.Hydromaasage Bathtubs No.of Motors Total HP a ecommun De ca ons g OTHER; No.of Devices or E ulvalent t ted Valu f Electri 1 Wo Attach additional detail ifdesired,or as required by the Inspector of Wires. � ;"" ±�Y � to Start: �� (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. i t c ' sl RANCE COVERAGE. Unless waived by the owner,no ,„ N e k censeeprovidesproof of liability permit for the performance of electrical work may issue unless 1311 insurance including"completed operation"coverage or its substantial equivalent. The igned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. ''' OH K ONE INSURANCE �� ' � ��e� `� BOND ❑ OTHER 0 (Specify:) f fy,under the pains and penahies ofperJury,that the information on this t.L1 mug N application is true and camp let :ic see: LIC.NO.: �� •'�� !scab! �---.___-- Signature y ddt as: es tpt" n the li use r line. LIC.NO.. 3 25. *Per M.G. .c. 147,s.�7- 1,securitywork � � Bus.TeL No. Ifilia — Lic.No. OWNER'S INSURANCErequires De airmen of Public Safety"S"License: Alt.TeL No.: WAIVER: lam 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/Agent ■ owner • owner's a:ent. Signature Telephone No. PERMIT FEE:$ C iYius-