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Home My WebLink AboutBLDE-22-000724 Commonwealth of Official Use Only (i1t Massachusetts Permit No. BLDE-22-000724 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:8/9/2021 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) 56 BOB-0-LINK LN Owner or Tenant MILLER MARISA Telephone No. Owner's Address 56 BOB-0-LINK LN, WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. • Existing Service Amps Volts Overhead 0 Undgrd 0 o New Service Amps Volts Overhead 0 Undgrd 0 C .of.'!R� Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement heater. O :_ Completion of the following table may berdCby h e f of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of j To1 Transformers t No.of Luminaire Outlets No.of Hot Tubs Generators 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 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices 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: 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: Matthew Gordon Signature LIC.NO.: 55830 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:22 Station Avenue, South Yarmouth Ma 02664 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 40 (7)1 K RECEIVED yy�� C mmanwaa[!h a/trtaeeachwatfe Official Use Only AUG 0 L 1 �apartmaaf o f a Sa Pc rmit No. 2 —O``��' `�f ra +' rv'cre cked BUILDING DO'.y,��'NT BOARD OF FIRE PREVENTION REGULATIONS [Rev. p (lenvnd eChe) .1 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 ALL INFORMATION) Date: /.!5 ) City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned ives notice of is or her intention�y perform the electrical work described below. Location(Street&Number) O 6—a)—L hi-f 0 gam/ gte ,j�j Owner or Tenant mdi-is a_ m i Iles— Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No.. (Check Appropriate Box) Purpose of Building Utility Au horization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty Location and N tare f Proposed Electrical Work: /^ i s� i Ilea( n�� h k eyiir� �5'�a17- �5 �'� �: �eA eY vs Completion of thefollowing,table may be waived by the Inspector of Wires. LbNo.of Recessed Luminaires No.of Cell:Sosp.(Paddle)Fans No.of Total Transformers KVA C,1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA 4 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting >zrnd. grnd. Battery Units `I 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 ill No.of Ranges No.of Air Cond. Totalo No.of Alerting Devices No.of Waste Disposers Heat Pump Number.Tons_.,_.KW No.of Self-Contained Tows: �� Detention/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑Municipal on ❑Omer Co No.of Dryers Heating Appliances KW Security Systems:" No.of Water No.of No.of No.of Devices or Equivalent Heaters KW Signs Ballasts Data Wiring: 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 o7 El rtriical/Work: t"c' (When required by municipal policy.) Work to Start:��f [A t Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE 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 ioy�rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE_, BOND 0 OTHER 0 (Specify:) I certify,antler the alns and nalties ofperju that information on this application is true and complete. f6 FIRM NAME: o a LIC.No.:,5 p 3()0 Licensee:P_ e 'o)S z)1 Signature LIC.NO.: (If applicab ent 'exempt"' the lice a number II''aaaeee�� ! Bus.Tel.No.•'3 6j Q77 Address(._a-C 0i✓j AVC eri 1 1 ) Alt.TeL No.: Per M.G.L.c.147,s.57- ecurity work re sires 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. 1 am the(check one)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ ----G