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Home My WebLink AboutBLDE-22-005887 Commonwealth of Official Use Only I , t 4441 Massachusetts Permit No. BLDE-22-005887 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:4/14/2022 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) 329 ROUTE 6A Owner or Tenant FIRST CONGREG CHURCH OF YARMTH Telephone No. Owner's Address ROUTE 6A,YARMOUTH PORT, MA 02675 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 0 Undgrd ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Split A/C, add sub panel, &replace cable from meter to panel.(GIFT SHOP) 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 ,Initiatine 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/Alertine 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 ❑ 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: JEFFREY T FOSS Licensee: Jeffrey T Foss Signature LIC.NO.: 36938 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 33 SULLIVAN RD,W YARMOUTH MA 026733543 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: $80.00 41_ k4 /(9/ ( j: emt) RECEIVED - mmonwealth"/ MamaehuuHa Official Use Only =y- ;PR 13 2022 � �� 7 ��// C� Permit No.P.;=:a�- , r�arGrunl o`,}in Jeraicee ' Ir,. iN U.NARTMENT Occupancy and Fee Checked ',,j� `___ DDARD_OF�JRE PREVENTION REGULATIONS [Rev.I/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Maasochuaens Electrical Code(ME 527 R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIOM Date: y///. , `� City or Town of: YARMOUTH )))To the Inspector of'Wires: By this application the undersigned rve notic of his or er intyat'ti to erform he, trical work described below. �O Location(Street&Number) j, y C�!`//?j' f � Owner or Tenant /�N' C C/V Glyi / p >-'�/"-I 1 CH/<�C/'� Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No,1 (Check Appropriate Box) Purpose of Building Utility Ant orization No. Existing Service/00 Amps 7 /�p Volta Overhead Undgrd❑ No.of Meters New Service Amps / Volts Overhead Undgrd g ❑ No.of Meters V? Number of Feeders and Ampacity Location and Name of Proposed Electrical Work: �/' S if. (I1 Loo5file vl Completion of the following.table my be waived by the brs actor of Wires. il,. No.of Recessed Luminaires No.otCell:Sasp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA rL, a No.of Luminaires Swimming Pool Above In- No. m grad. grnd. 0 BatteryofE Unitsergency Lighting No.of Receptacle Outlets No.of OB Burners FIRE ALARMS INo.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 No.of Waste Disposers 'Rest Pump I Number'Tons I KW 'No.of Self-Contained Totals: .... .... _l. _.. Detection/Alert(n Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection 0"her No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.ofNo.of Devices or Equivalent Heaters ' Data Wiring: No.ot 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 EI tric Work: (When required by municipal policy.) Work to Stan: L / ',, Inspections to be requested in accordance with MEC Rule It,and upon completion. INSURANCE C �,l GE: 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 M OTHER 0 (Specify:) C e'/7eIJ � �•Ca /o I certify,under the pains and allies of perjury,that the information on this a p ication is true an complete. FIRM NAME: LIC.NO.: / Licensee: cy /I Signature L 31 q 3 e/ (lfapp/icubl enter"axeypr"//,n�t!l��"ee li a number'Irq ) LIC.NO.: D/9 O Address: 3 SL%/, �(, �'� / /J/�j,,,t rfj A/�yi t 0)/7 Bus.TeL No.• /'J0/ Per M.G. c.147,s.57- security work requ res epartm t of u lie Safety 7 icense: Alt.L,iTc.No. ��" r��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 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:S 1