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Home My WebLink AboutBLDE-23-004131 r 011 Commonwealth of Official Use Only trif- % Massachusetts Permit No. BLDE-23-004131 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:1/26/2023 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) 668 ROUTE 28 Owner or Tenant MANNING GERALD TR Telephone No. Owner's Address THE PARKER RIVER REALTY TRUST, 121 MAYFLOWER TERR,SOUTH YARMOUTH, MA 02664-1120 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: Relocate exit sign&run new circuits for heaters. 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 1 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 Initiatine Devices No.of Ranges No.of Air Cond. Tn Total No.of Alerting Devices 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 Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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: Rex A Burger LIC.NO.: 17037 Licensee: Rex A Burger Signature (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:2045 MAIN ST, MARSTONS MLS MA 026481864 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. I PERMIT FEE: $100.00 I aN)CQ tt- (7)7(23 Y 6,1„ 23 J � 91✓4 r Commonwsatth o/r//anaachuastte Official Use Only V • . '�,,' r, slvartmsnt o�,}irs Jsrvicse 0 -f" ..1 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) 1J. 1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code EC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / (3 / a b� 3 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 elegirival work described below. Location(Street&Number) (j) fif• a g" (,. l fQr6tt6� t r^ Owner or Tenant -3-e r y\ _M a A a,u c C4 p•f . Pat k,2.r S Telephone No. Owner's Address 4 4.3 Ka $ h... . ,)at ifi is,.,G< M 4- Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Ap propriate ppropriate Box) Purpose of Building Re 4-cr.ru k f. UtWty Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters j New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters _,__Q Number of Feeders and Ampacity MO v.,_ e�(f S 15,1 I r u IA t..( ct V. C.L.tfS s— Location and Nature q.f Proposed Electrical Work: ° -CO- 4 h.h ,wc 14e_j-t5 'I) Completion of the followin&table may be waived by the In vector of Wires. tii No.of Recessed Luminaires No.of Ceti.-Susp.(Paddle)Fans No.of Total Transformers KVA C No.of Luminaire Outlets No.of Hot Tubs Generators KVA ra mot: No.of Luminaires • Swimming pool Above ❑ In- No.of Emergency Lighting grad. 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 ti Initiating Devices Toi•t No.of Ranges No.of Mr Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump lumber Tons KW No.of Self-Contained Totals: "�' "" Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Locel Municipal ❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent • 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§{ 31 Q D c) (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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [ BOND 0 OTHER 0 (Specify:) I certify,under thees pains ged penalties of per jury,that the information on this application is true and complete. FIRM N E: ( ex i t S@.y t�lec`f-vtc 4 i -4. G LIC.NO.: A 00 3 7 Licensee: IL .o..� Signature LIC.NO.: (Ifapplicable enter"exempt in the license number line.) Bus.Tel.No.seB 3 3d b q$3.— Address: rv�'f S Al a.rl S1=• Mn,S nS /4(((c AA A Alt.TeL No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. Ism the(check one)0 owner 0 owner's agent. Owner/Agent I Signature Telephone No. I PERMIT FEE:$