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Home My WebLink AboutBLDE-23-003493 Commonwealth of Only ljti1•'of r� Official Use Massachusetts Permit No. BLDE-23-003493 "*.;-'; 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:12/27/2022 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 elect ' work described beto Location(Street&Number) 70 OLD MAIN ST D L Q CY qZ,,L. Owner or Tenant K BE ..0F Telephone No. Owner's Address C/O TD BANKNORTH NA TR, 90 PEARSON BLVD AT:CHARTKOWSKI, GARDNER, MA 01440 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: Install 18kw generator. 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 0 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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection ❑ Other: 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 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: 12/22/2022 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 operjury,that the information on this application is true and complete. .f FIRM NAME: Jack W Griffin Licensee: Jack W Griffin Signature LIC.NO.: 418 (If applicable,enter"exempt"in the license number line.) Address:26 JOANNA DR, S YARMOUTH MA 026641339 Bus.Tel.No.: *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 fie" (wo 4A4.: etwa5:4190 i4 (z , :. _,e____c! _-� C GEC 2 2 2022 Commonwealth ''4r. dG ut=PARTMENT � �sac�ueaffe Official Use Only ---Iz, �r.:lit wa,J cca�l cc�� n is „ _Js/oartmsnf a�}iro Jarwcsd Permit No. c---:. L 3 -3'1`1; `r- `' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Y [Rev. 1/07] leave ----- blank 0 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO RKAll work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 j (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dater a a aa- J City or Town of: YARMOUTH To the Inspector of Wires: . ` By this application the undersigned gives notie,e of his or her intenti9nto perform the electrical work described below. Location(Street&Number) O/ 4)' r Owner or Tenant /) CO i•Q .C1 Owner's Address �, Telephone No. fit( Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters Nev___ ___vice f U D Amps 1 Z.o Volts Overhead Number of Feeders and Ampaeity Undgrd El No.of Meters Location and Nature of Proposed Electrical Work:i N S J 6 6-2t As ts Completion o the ollowin_ table m be waived b the Ins ector o Wires. e, No.of Recessed Luminaires •./ No.of Cell:Susp.(Paddle)Fans °'° ota No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA ' No.of Luminaires Swimming Pool :rnd.e ❑ n- ❑ 'o.o mergency g mg �` No.of Receptacle Outlets � Batte Unfts 7, No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches Na.of Gas Burners 'o.o t etectton an t t g No.of Ranges Initiatin 1 Devices No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers 'eat 'ump `um er oats ' " Totals: et o e - onta no No.of Dishwashers Detection/Alertin, Devices Space/Area Heating KW Local❑ 'un cma No.of Dryers Connection 0 Other r7 Heating Appliances KW ecu ty ystems: o.o "a er .o u No.of Devices or E I uivalent Heaters ' O.o Data Wiring: Sins Ballasts No.of Devices or E a uivalent No.Hydromassage Bathtubs 'No.of Motors Total HP a ecommun ca ons " r g; No,of Devices or E uivalent OTHER: Estimated Value of E ectrical Work: ,,� + Whentach additional yemu i municipal lic ys required by the Inspector of lf`ires. Work to Start: /Z —_=--- (When required by municipal policy.) dQ. Oa, Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO ERA E: 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 cover ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND I certify,under the pains and penalties ofprr OVER 0 (Specify:) FIRM NAME: ` a-C�� jK�•that the information on this application is true and complete. � �J Licensee: a-t✓je, �'r t rr_fil LIC.NO.: � r 3- (If applicable,enter" empt"nz Jhe license nu er line,) Signature LIC.NO.: Address: "WA v/ Bus.Tel.No,:975s �/1__q a l *Per M.G.L.c. 147,s.57-61,security work r qt yes Department o Pub c SafetyLie.No. S"License: Alt.Tel.N..: OWNER'S INSURANCE WAIVER: am aware I a aware that the Licensee does not have the liability insurance coveragenormally required by law. By my signature one below,I hereby waive this requirement. I am the(check Owner/Agent ❑owner owner's a:ent. Signature Telephone No. PERMIT FEE:$