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Home My WebLink AboutBLDE-22-001656 Commonwealth of Official Use Only tr�. Massachusetts Permit No. BLDE-22-001656 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:9/22/2021 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) 300 BUCK ISLAND RF .� •,` Owner or Tenant CURRIE KATHLEEN Telephone No. Owner's Address 300 BUCK ISLAND RD UNIT 6C,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Approp Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 M New Service Amps Volts Overhead ElUndgrd 0 o. t t >� Number of Feeders and Ampacity `) i 9 Location and Nature of Proposed Electrical Work: Replacement furnace ;." .zAN i� d Completion of the following table may be waiv ec r /'Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of f _ . Transformers ` r `\ No.of Luminaire Outlets No.of Hot Tubs Generators Y?.....4 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 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 Devices or Equivalent No.of Water KW' No.of No.of Ballasts Data Wiring: Heaters Siens 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: 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 Kit /,%v , (1t& n dNJ N ig1 Commonuwsa[th o/MAWCha40tid Official Use Only `" v, r Permit No. `r22�(.625 (O c\i f epartmenI o/.Ju.i &rviced cked 0 W u`'• a., ,,.J BOARD OF FIRE PREVENTION REGULATIONS [Rev1/0]Occupancy (leave blank)d Fee Cnk z APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK J x 1 co x All work to be performed in accordance with the Massachusetts Electrical Code C). 27 CMiR 12.00 • EASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7f 22 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersi ry notice of his r her intention to orm tb electrical work described below. Location(Street&Number). es C' 2 /qi h rof < ' Owner or Tenant Jet 1 e r IA �IA r ies i e Telephone No. ,5'CD‘ 3155'6 '/ 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❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: / 1y, `e r s)_.c-t-e vt ) Completion of the followin&table m be waived by the Inspector of Wires. U No.of Recessed Luminaires No.of Celt-Snap.(Paddle)Fans No.of I Transformers KVA 4=1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA n -4 No.of Luminaires Swimmin pool Above In- No.of Emergency Lighting g Qrnd. ❑ grnd. ❑ Battery Units .12 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches �No.of Detection and No.of Gas Burners Initiating Devices 1 1.k No.of Ranges No.of Air Cond. Tunsl No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers S ace/Area HeatingKWMunicip p �0 Cyyonnection 0 Other No.of Dryers Heating Appliances KW Security Devices or Equivalent No.of Water s KW No.of No.of Data Wiring: HeaterSigns 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 Va1u f Electri I Work: , - V (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVE 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 MI BOND ❑ OTHER 0 (Specify:) I certify,under the pains and nalties of perjury,that information on this application is true and completes g FIRM NAME: P 0 f t 11 LIC.NO.: j�� Licensee: J 014 Signature == LIC.NO.: (If applicable/enter"exempt"in the l erase wiper line.) Bus.Tel.No.;�263.6e06007 Address: t r 0 ( ' i of i� , ��7 L[r1 co/7n 1 - Alt.Tel.No.: *`Per M.G.L.c. 147,s.57-61,seem*wo 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$