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Home My WebLink AboutBLDE-22-002520 Commonwealth of Official Use Only 4111104+4) Massachusetts Permit No. BLDE-22-002520 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:11/3/2021 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) 979 GREAT ISLAND RD Owner or Tenant MERCK WILHELM M Telephone No. Owner's Address BRADY JOAN, 1032 BAY RD, SOUTH HAMILTON, MA 01982-1104 Is this permit in conjunction with a building permit? Yes 0 No ❑ (C ec: -1 . ' • e Box) Purpose of Building Utility Authorization Existing Service Amps Volts Overhead 0 Undgrd New Service Amps Volts Overhead 0 Undgrd 0 N e s Number of Feeders and Ampacityr 4 Location and Nature of Proposed Electrical Work: Install sub panel in shed with GFI receptacle&50 amp recepCer), G(i4,40 Completion of the following table mector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of otal 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 2 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 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 Devices or Equivalent No.of Water 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: Charles H Furman Licensee: Charles H Furman Signature LIC.NO.: 50135 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:92 SPRUCE ST, N ATTLEBORO MA 027601920 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 [0- .0"illtqq, ', NOV 0 1 1111 Commonwealth.4 maeeactseerite Official Use Only • . _, c� Permit No. 12-- S L „ =N T .1Jsparimeasi 4 irs�iCai f3UI: ING a� j By ""— Occupancy and Fee Checked I BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1ro71 (leave blank) 1 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 INFORMATION) Date: ! 6 - /- 2 1 City or Town of: A,ro J4. To the Inspector of Wires: S By this application the undersigned gives notice of his or her intention to perform the electrical work described below. _9 Location(Street&Number) q-7 Cj 6 r[f"T S`,-v ZL ,,, Owner or Tenant /..),7 A et 04,1 /'/1n 1e r�k Telephone No. 4 0 3 5-3/Sd 05 - �' Owner's Address �y Is this permit in conk with a permit? Yes 0 No..Er (Check Appropriate Box) c) Purpose of Building �-s ' Lc.. ;h L Utility Authorization No. d Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters L Number of Feeders and Ampacity Location and Nature of P h ..2":":-,1 Electrical Work: f 1.c, i I T i 6 _10,, A. L... eO4 /•-1 SA c i - Lr /i /.." 6 P.2 4"a( /— 2 t/o V g o A- Pi Ld, SI Completion of the folowing_table n be waived by the! of Woes. Total tit No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of C.:: Transformers KVA Qt No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting gm& ernnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switelus No.of Gas Burners Na.of Detectionand Initittthm Devices Total 11,1 No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Heat Pump Number.#Tons KW No.of Self-Contained Totals: _ Detection/Alerghgpevices No.of Dishwashers Space/Area Heating KW Local 0 Mu 0 Other No.of Dryers Heating Appliances ICW Na‘Security or Univalent No.of later No.of No.of Data Wiring: Balla Heaters KW Signs Ballast* No.of Devices or ' , 1 -:t No.Hydromassage Bathtubs No.of Motors Total HP TNo.ofDevices or p i , t OTHER: yb , U 0 Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: .2 (When required by municipal policy.) Work to Start: if—/—2 1 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 coverscoverafie is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I cm*,under the pains and penalties ofpehw',that the information on this application is true and complete. FIRM NAME: �U r/v..4." /'e c.Tfr ,'c /aL C.G- LIC.NO.: K'I q l di Ucensee: C `r'let r /rat.- .4-� Signature �`e LIC.NO.: r3'v/3S- applicable,enter" t"in the license monk?.tine) Bus.Tel.No.: ?7`/2W I4,�2— Address: r✓G e- 57 N ,47r1 h /1/4- O2?t c Address: �2j� , � v r� // Art.Tel.No.: "Per M.G.L.c. 147,s.57-61,security work requires 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)0 owner ❑owner's agent. Signature Telephone No. (PERMIT FEE:$ 50---