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Home My WebLink AboutBLDE-21-005387 V Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-005387 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:3/19/2021 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 etecmcal work described below. Location(Street&Number) 583D FOREST RD UNIT 4 _ Owner or Tenant BAKER MEREDITH R TR Telephone No. Owner's Address THE BAKER FAMILY TRUST,110 VALHALLA DR,SOUTH YARMOUTH,MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropr Box) Purpose of Building Utility Authorization No. Q /\ Existing Service Amps Volts Overhead 0 Undgrd 0 4:::, Me((rp�VA, New Service Amps Volts Overhead 0 Undgrd ❑ e i& '' Number of Feeders and Ampacity /� ' Location and Nature of Proposed Electrical Work: Upgrade lighting.(ASSOCIATED ELEVATOR) (/JOB) nA Completion of the following table may be ivice •V o (Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of _�JIC Transformers �/� 4 No.of Luminaire Outlets No.of Hot Tubs Generators 3 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grad. 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 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 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: 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: PAUL M MORRIS Licensee: Paul M Moms Signature LIC.NO.: 17520 (If applicable.enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 213,1 COUNTRY WAY,SAGAMORE MA 025610213 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 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:$80.00 l..onunonweaig o/Va. achuoaii3 Official Use Only "� 'a 'WOW' ''� c� Permit No. L 2� I � t v Theparfinent o/.ire Service.4 '. ,31 Occupancy and Fee Checked ' ;' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APP UCATOO FOR PERt.;III TI PERFORM ELECTI1CAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: -3 J i ZJ 2,07./4 City or Town of: VA-. o the Inspector of Wires: By this application the undersigned ves notice of his or her intention to perform the el trical work described below. Location(Street&Nu, her) 2 it Q44 �p r L Owner or Tenant r Telephone No. 66 7 L i L' Owner's Address 5 DCA es)� 0 LJ _Q _ 3 O 3 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps I Volts Overhead ❑ Undgrd Ll No.of Meters Number of Feeders and Ampacity #Location and Nature of Proposed Electrical Work: ! e"'fa. g @ ft J t efi c. L ,,,'v • Completion of the.followinEtable may be waived by the Inspector ofWires. 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 grad. grnd_ Battery Units i No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones F No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. - Total No.of AlertingDevices /' 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 ILocal❑ ConnectionLj Other , No.of Dryers Heating Appliances KW Security Sy ttetns:" No.of Water No. No.of Devices or Equivalent of No.of Heaters Signs Ballasts Data Wiring: No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total gip 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 Inspections tcgAtrequested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERA 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE �r BOND 0 (Specify:) 1� ❑ OTI�R I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME:TN rrin 'FA e , LIC.NO.: Licensee: -'d na l) ,- r-j g..2 I a hemoo„ '�� LIC.NO.: �'1 1s`'.-` (f pp • abl rrter"exempt"in the license number line.) Address: 6 '-1 2 d 3 ,5" ,�-P q k Pi 0.2 Bus.Tel.No.: `Per M.G.L. c. I47,s_57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No. OWNER'S INSUFANCE 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/Agent ❑o er's a tint. Signature Telephone No. PERMIT FEE;$ , ,j- Pit i P.-/ a:. R C.0...,4!>_ CM . our" - ' • . • • . - - - r•. • . • • •