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Home My WebLink AboutBLDE-22-001062 Commonwealth of Official Use Only s :� Massachusetts Permit No. BLDE-22-001062 ''—• 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:8/24/2021 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 electrical work described below. Location(Street&Number) 597 FOREST RD Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address CENTRAL DUMP, 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ap rOr Box) Purpose of Building Utility Authorization No. A Existing Service Amps Volts Overhead 0 Undgrd 0 , o `Tty�• O New Service Amps Volts Overhead 0 Undgrd ❑ .0 v tt• . �1 Number of Feeders and Ampacity I f Location and Nature of Proposed Electrical Work: Data/Comm cabling (PUBLIC WORKS BUILDING) O O O Completion of the following table may a' e ` • Aor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.ofTransformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA 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 Ballasts Data Wiring: 8 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: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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:$0.00 RECEIVED AUG 2 0 2021 a,/� r{�yy�� BUILDING DEI'A T COm00....tik o`rriaaaackteette Official Use Onl /�_n/ By --_. "7ft cc77,, c7 �i Permit No. t-.-' L'L/([J V ' �.. r. arparfinenl of Jiro Serviced . Ii BOARD OF FIRE PREVENTION REGULATIONS Occupancy0 and Fee Checked (Rev.l/07] (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 INFORMATIOM Date: QJ ,/ City or Town of: YARMOUTH To the InspBcto of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) $°7 1-wirr}pi) 4,.,,5 22.e6- .fiUr//y"),, r../ Owner or Tenant rA/vIV 6, AGsts.,r// Telephone No, 14 ?if-?d.JI I Owner's Address i/YL /QT fa,rff 1/ilwtirr// I Is this permit in conjunction with a blinding permit? Yes ❑ No a (Check Appropriate Box) Purpose of Building I),k poisi_L Liam,.,( r5 -h-6. Utility Authorization No. Existing Service jp Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service /A Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty A//is Location and Nature of Proposed Electrical Work: C'LG9c.),,P E[r2Y:ek'' Qn;R /rto✓i'T/riW eu,— /:-Vx[/l rkik Arlo a7 4.4J /)a:.r A- I7La.- Otfi(. Aar d M its 2-wgz'6p> Completion of the followingVhle muy be waived by the Inspector of Wires. TotaI lbNo.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans No.of KVA ,./ Transformers KVA C No.of Luminaire Outlets No.of Hot Tubs Generators KVA d" No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting prod. g nd. Battery Units ::,." No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners Teo.of Detection and Initiating Devices 11' No.of Ranges No.of Air Cond. Toosi No.of Alerting Devices No.of Waste Disposers Totals: Pump Number.,Tons___ K_W 'No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑Municonnection ipal ❑ , No.of Dryers Heating Appliances KW Security Systems:* Devices or Equivalent No.of Water KW Heaters of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent r No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: f' Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: )963.' (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C 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 cooveeDge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE[V7 BOND❑ OTHER❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: , (k[FAO iLlri7.inLiT LIC.NO.: 17o Licensee: Ll /272.7 [pyt7AC Signature �/r),,/ ./ds LIC.NO.: !! (If applicable.enter"exempt"in the license number line.) J ` Bus.Tel.No.:T,t/ 7t Address: Alt.Tel.No.: Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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. I PERMIT FEE:$