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Home My WebLink AboutBLDE-22-001064 • Commonwealth of Official Use Only Permit No. BLDE-22-001064 Massachusetts �' ` 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) 99 BUCK ISLAND RD Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address WATER DEPT, 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463 � Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ap, , Ti. ' i x) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd 0 . O New Service Amps Volts Overhead 0 Undgrd 0 40 . 'Mrs h Number of Feeders and Ampacity 8,61 'rf' Location and Nature of Proposed Electrical Work: Data/Comm cabling (WATER DEPARTMENT) d .P Completion of the following table m f/ a' d s.4,1) r of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of rr ��777 Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- ElNo.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. Tonal No.of Alerting Devices 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 p 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: 7 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 REc, E1L 'ED A1 1 r z O /� A/ ��..y�/i U17 CommonwraiR.ei t menenroalta OfFcial Use Only cc-7� nr� Permit No, (,(/ g ll L[3 i v" .' _ rloarlmrni al Ji.r-Cervices Z' t, 11 ?. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.I/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: r ao,)) City or Town of: YARMOUTH To the Inspec(or of Wires: By this application the undersigned gives qno�tice of his or her intention to perform the electrical work described below. Location(Street&Number) 9' /�iJ[,_lZLr743 /fin G/ts-.-pailhu,7/ Owner or Tenant T' k fMd✓D/ Telephone No. d� D/rN At- P S 39f da3/ Owner's Address /�71 A' of f2r. 'i yNAinazi A/ I� Is this permit in conjunction with a building permit? Yes El No La (Check Appropriate Box) Purpose of Building hho7A paw,2 rfkFivi Utility Authorization No. Existing Service 4,5 Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service "IA_ Amps / Volts Overhead❑ Undgrd El No.of Meters Number of Feedend Ampacity /V/� Location and Nature of Proposed Matt cal Work: i,srvurrrrav oP 7.t-z'a.: derq 7✓4a,,i.✓/4,r I//e &J/n.1706-, GtGa.vi1/ACZ-Mnr-444re �..41'.TivG c'n6tc Completion of the followingtable may be waived by the inspector of Wires. Ut No.of Recessed Luminaires No.of Cell.-Sus No.of Total p.(Paddle)Fams 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. grnd. Battery Units 7.'2 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of Detection and K— No.of Switches No.of Gas Burners No.Initiating Devices 11, No.of Ranges No.of Mr Cond. 000i No.of Alerting Devices No.of Waste Disposer HeatPump Number,Tons..,,,_,KW No.of Self-Contained Totals: ".... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipa ❑Ofh� Connection No.of Dryers Heating Appliances KW Security Systems:* - No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent 7 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: n7/do. (When required by municipal policy) Work to Start: it of,7/ Inspections 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 covers is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Fr- OND ❑ OTHER❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: —' i227PD /Il£i-402K- LIC.NO.: n/in Licensee: GJSI[ZZ r'CdK1L1K Signature /, LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.. 54/�/,T-76J1, 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: 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 ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$