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Home My WebLink AboutBLDE-22-001998 . ... Commonwealth of Official Use Only {��„� Massachusetts Permit No. BLDE-22-001998 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:10/7/2021 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) 174 ROUTE 28 A Owner or Tenant Salvation Army Telephone : i Owner's Address \ , r ,1 Is this permit in conjunction with a building permit? 1'cs 0 No 0 (Check Appro �,priate Box) -'v. Purpose of Building Utility Authorization No. t ,,/` Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Metet , :: New Service Amps Volts Overhead 0 Undgrd 0 No.of Me rs VNe' ' 7 Number of Feeders and Ampacity71( N Location and Nature of Proposed Electrical Work: Upgrade lighting(Per attached) (SALVATION ARMY STORE) Completion of the following table may be waived by 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 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 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: 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: JOSEPH V SLOWEY Licensee: Joseph V Slowey Signature LIC.NO.: 11186 (If applicable.enter"exempt"in the license number line.) Bus.Tel.No.: Address: 168 WATERCOURSE PL, PLYMOUTH MA 023603629 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 RECEIVED CT 07 2021 �r t....ommonwsaCtes o`,assaci(iusotL+ Official Use Cml ,, • ,aEPARTMENT e • cc-�� cc�� , Permit No. i V ; 1 ! V' — — . sparfmsnl o lira ervrces Occupancy and Fee Checked ,� BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] (leave blank) f APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 , II) (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: J O ' 3 ' ad,J `' City or Town of: •(c{c mr;c h To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. eJ Location(Street&Number) 1 7'-1 .010,410 5 i Owner or Tenant -ttvo:tIto fl(lYl Telephone No c..) , Owner's Address C'c r17 aCT * 1-a/ —:5Dg ')7/ '03 O 7 Is this permit in conjunction with a building permit? Yes � No E (Check Appropriate Box) 0 Purpose of Building icon 1 RA 1 f- Utility Authorization No. �� Existing Service Amps / Volts Overhead Undgrd I I No.of Meters — New Service Amps / Volts Overhead❑ Undgrd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1 it ti v.ci i i f eQjlc ) iCISA. 'tc cf --,3 he a,� ._ c Linv I f 'tt t - la h CG) J t�kts Completion of the following�table nun,he waived by the In vector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVo ta A Ay Qt No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting ▪ No.of Luminaires Swimming Pool grnd. ❑ grnd. Battery Units ▪ No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 't N .onletectlon and No.of Switches No.of Gas Burners Initiating Devices Ill No.of Ranges No.of Air Cond. Total g Tans No.of Alerting Devices No.of Waste Disposers 'Heat I mp Number Tons KW No.of Self-Contained spose Totals: . Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Monneunicipal ction ❑ C _ C No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water N .of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNofDevices or Equivalent No.of Devices Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires, Estimated Value of Electrical Work: j5 .— (When required by municipal policy.) Work to Start: i D•''' dv 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ji4 BOND ❑ OTHER El (Specify:) I certify, under the pains and penalties of perjury,that the information on this applkatian is true and complete. FIRM NAME: J J S --I ec A 11G tCt r) LIC.NO.: Licensee: , \to 1 D t,,P.tit Signature9 11(1-�y LIC.NO.://f�(c.13 (If applicable,enter"exempt"in the li erase number line.) / Bus.Tel.No.:,3Z'S'illg Address: Alt.Tel.No.:' 3at(i ,;19,8z0 *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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ --C) —