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Home My WebLink AboutBLDE-22-001059 - gate house - Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-001059 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 ( ec 4 to Box) Purpose of Building Utility Authorization o. Existing Service Amps Volts Overhead 0 Undgrd h etos New Service Amps Volts Overhead 0 Undgrd 0 ,6 ` . + s Number of Feeders and Ampacity /� O Location and Nature of Proposed Electrical Work: Data/Comm cabling. (GATE HOUSE) U 4 . Completion of the following tabl �}�'4•.io • nspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of / Total Transformers 44 , 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 Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 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 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: 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 E' CEIVED [pus 2(12[ 1 �l, ......--- Permit Commonwealth of///aeeae4uao(}a (-Of'ficyia�l Use Onl BUi�o NG a ..B:._-'•�T cc�� cc77 �J No. C Gam`— ((USq -t.=y, �� 2epartmenl of.Jim.-�emkse I'"_ - i,II i,-ai Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (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 ALLINFORMA77ON) Date: p�ale o2/ City or Town of: YARMOUTH To the InspEctorofWires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) j 97 /-74 i/ A .z.,-;67..tr..c./ Jbua/yAu,,s Jrr/ Owner or Tenant /O,,u bF)/L 5J Telephone No. ,so¢ 39 _ , Owner's Address I/9/L Ri„.7' -O,,i,o )/ ,ne,,-71' Is this permit in conjunction with a building permit? Yes ❑ No Er (Check Appropriate Box) Purpose of Building DPW (S'04 rA L leg.c;9 CAX/kat Utility Authorization No. Existing Service A, A Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service ,t/J,, Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty i7 , Location and Nature of Proposed Eledrl Work: PT-rG%jr7r.VA.7 t fX.,,,,, ..,pan,/5eA'.or..o .gun svri Completion of the followinKtable may be waived by the inspector of Wires. W No.of Recessed Luminaires No.of Ceil-Snsp.(Paddle)Fans No.of Total r1 Transformers KVA nNo.of Luminaire Outlets No.of Hot Tubs Generators KVA d' No.of Luminaires Swimming Pool Above In- ❑ No.of Emergency Lighting grnd. grad. Battery Units 'r No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and 5. Initiating Devices Ill No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: . ............................ Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 Mun[nnecictiopan Otlar Co No.of Dryers Heating Appliances KW SecurityN f beam s or Equivalent No.of Water , 'No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent ,2 No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: :8 ti Attach additional detail If desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 7/(. (When required by municipal policy.) Work to Start: ,//,/f/d, Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CQYERAGE: 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❑ (Specify:) I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: 1.IEei t) ,4,4$: LIC.NO.: ,f/�jy Licensee: /dik fit (ewe?A/( Signature / , I' LIC.NO.: (If applicable,enter"exempt"in the license number line.) J,J Bus.Tel No..(4,l)2L./"717d Address: Alt.Tel.No.: Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: 1 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:$