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Home My WebLink AboutBLDE-22-006857 Commonwealth of Official Use Only _` Massachusetts Permit No. BLDE-22-006857 %77 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:5/26/2022 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 electrical work described below. Location(Street&Number) 45 WINDJAMMER LN Owner or Tenant Peter Collins Telephone No. 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 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: Disconnect for air handler. 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 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 Initiating Devices No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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: 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 o RECEIVED1 (2 ._... aa�o/V9addachudaifd Official Use Only �f i. MAY 2 5 L"° /- Ii,< , c� c-� (� Permit No. �Z-- e 57 . ,_ .,, _ s o/.}Ira Serviced 1i. r G DEPARTMENT *' 15 gU OF FIRE PREVENTION REGULATIONS Occupancye . /077 and Fee Checked leave blank 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: 6,/2 c/L,2 City or Town of: YARMOUTH To the Inspec(or of Wires: Ng By this application the undersigned/givstootice of his or pler intention to perfor�telectrical work described below. Location(Street&Number) 11 IVr i ek 1Y►1W}e.r l; ,mob Owner or Tenant Pc t r,'Y r'U I /, rl 5' Telephone No. 5 G ' 7 6 1" C 27 7 Owner's Address Is this permit in conjunction with a building permit? Yes 0 NO (Check Appropriate Box) Purpose of Building Utility Authorization No. rJ; - Existing Service Amps / Volts Overhead❑ Undgrd El No.of Meters 1t\ New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location an Nature of Proposed EIWork: /' ' 0,7 rical . (' �_ ,� J � !� �JSc�tv�'C' uCompletion of the followink.tabk may be waived by the!n ector of Wires. l!a No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans No.of Total `,,,, Transformers KVA Z No.of Luminaire Outlets No.of Hot Tubs Generators KVA t No.of Luminaires • SwimmingPool Above In- ❑ No.of Emergency Lighting grnd. ❑ grnd. Battery Units �t No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and '' Initiating Devices Tota11,E No.of Ranges No.oIAir Cond. Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal p Local❑ Connection C 3 °ther No.of Dryers Heating Appliances KW Security Systems:* No.of No.of WaterHeat s KW No.of No.of Data Wiring:ices or Equivalent 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: ,5,j 0 (When required by municipal policy.) Work to Start: 5 i y j 2--7._ 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 the pains and penalties ofpe ury,that the informa on on this application fs true and complete. FIRM NAME: " et 72 /' V' 0j LIC.NO.: SS ,' 0-at' Licensee:j-1 r I,v 10-i 6S dov, Signature- ' LIC.NO.: (If applicable,e r"exempt"in the li ens number line — us.Tel.No.: i ^ � h 6 0-77 Address: r '-t IA . ,,f v' Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security 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 [J owner's agent. Owner/Agent I Signature Telephone No. ( PERMIT FEE:$