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HomeMy WebLinkAboutBLDE-23-000698 Z 1 - +ems;Y- i N : ck2 Commonwealth of Official Use Only ~� �` � Massachusetts Permit No. BLDE-23-000698'E 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:8/11/2022 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) 1175 ROUTE 28 Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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: Up[grade service&renovations of building. (Up to ten inspections)(F/A not included on this permit.) 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. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 Eauivalent 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: SYSTEMS CONTRACTING Licensee: Robert Barnes Signature LIC.NO.: 22651 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:7 Scobee Circle, Plymouth MA 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 /j Telephone No. PERMIT FEE: $2.405.00 ()Yiii ! `�l fir ' ,� °( Si-re,v2)/ ra-Aai ,e n or s � -Q( �� 1 RIO cife (PIN 01) (09/7)-x . SG atho; ei4.6 c-4Notz- rzitili '4- 2 k(23 (C A7e4d2i44-Pikitli- +N`� ° !o o 3gCS cat ‘%./ Oii s i2Sow x/2.6 /0..I(041 z/u/zz tie BAJ StT /02A I l o 126 t l9 "-* < go-u3 tl t26$ ati ofit 1 imill to0y nb 27 i05 Ilc t2$ �J7 1'/ pza 12,3 25 -act rl A raw 12p Z1-C 1.52)k z' '4/23 -CNP-S. 2 1 2-1 y.S ztc t1S z1'1 ri3 l2'L ljl 1-1,1 1 ct A zz z I(6 zip to u 8 to6 �Z8 21� `i i l2� 205 toot l A- 14,3 tol �3 l0(v '� Z tog q l-v t 0 3 Cr02- lz9 ttP, lz8 ((1�0�� to, o 7-03 209 ?�6 ZAS �,g co 0/0 ii7 8 t 2AL 223 r _ , . U G C Z 1 1\( „\,)) fit (Z rye) qNlvd. 2a 0 A. 6 o st « Ste. -3 ti PPP' Ce 1" 14F . . . . - :-411118184WY. .V..,.ti...:7.. 4.....--..- , sz!. , . meow . . . . . . . . . . . . . . . - . 1 I I . . • .... . . e .14 Commonwratth o`t/ladeachuNtte Official Use Only •/ cc//�� c� Permit No. 1.)espartmant ol.tires Srrvicre ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] (leave blank) V ;i APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ( All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR l2.00 s (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7 f ,-7 /? w City or Town of: I 014. To the Inspector of Wires: •4- By this application the undersigned gives notice of his or her intention to perform the electrical work described below. �. Location(Street& Number) 1 ( , a B 0 Owner or Tenant L _c\et. (. C r7 i tr".Wr)•-r-.*Ave Telephone No. iu Owner's Address M 18 Y,TS 2 ',./cr 14.44 14 Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) l Purpose of Building _3 c 1r-\c0 Utility Authorization No. Existing ServiceV Amps (01G /�,- Volts Overhead E Undgrd© No.of Meters : New Service I IBC Amps j,Au 1.,?Gt Volts Overhead ` Undgrd© No.of Meters : Ji Number of Feeders and Ampacity .3 ce 4- o it s 1 ii-t n., 1 j A.1 % �r Location and Nature of Proposed Electrical Work: P .2.4:Li G 1,,.,8 tr.--)c.5t-',r Sc-A-.,,r3 1 E$ /�dc� pra._ 'r w r-,nc� c3►-,�„ rc Pr\c<cto .,vC.o.�.., ` rec)sr-, CCar v.. Completion of the following table ma be waived by the Invector of Wires. `' No.of- t1 No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA Z KVA C No.of Luminaire Outlets No.of Hot Tubs Generators Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool 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. InitiatinnggDeteon and In Devices i;' No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices No.of Waste Disposers Heat Pump Totals: Number Tons KW No.of Detectionlf-Contained /Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Connection No.of Dryers Heating Appliances KWSecurity Systems:* No.of Devices or Equivalent No.of Water K`,i, No.of No.of Data Wiring: Heaters 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: (When required by municipal policy.) Work to Start: - .t - 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 EL BOND © OTHER 0 (Specify:) 1 cerre,under the palm and penalties of petjary,that the information on this application is true and complete. FIRM NAME: 5'- SIt-e s v k c. c \ _,,. ` LIC.NO.: 23e A 1 Licensee:,.t'c>•.- - g c=r rS c> , Siptatnre _...,e -1'orG LIC.NO.:,.�ss,-,`t A (If applicable._attar"exempt"in the lkense number line„j Bus.TeL No.:SLG 7•-1[. b oo 1 Address: Co)c C. : sir 1 V y f►-c.,Y1 Alt.TeL No.: StJl i ri fit. It'xiS 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ i .-_ _.� ,- ��c � �