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Home My WebLink AboutBLDE-21-007007 Commonwealth of Official Use Only Permit No. BLDE-21-007007 � 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:6/3/2021 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) 668 ROUTE 28 Owner or Tenant MANNING GERALD TR Telep'ols o. Owner's Address THE PARKER RIVER REALTY TRUST, 121 MAYFLOWER TERR, SOU H p '•�4 . -, MA 02664-1120 Is this permit in conjunction with a building permit? Yes 0 No he :�I o to Box) Purpose of Building Utility Authori A A Existing Service Amps Volts Overhead 0 Undgrd to 1.7 47 New Service Amps Volts Overhead 0 Undgrd 0 . i k . Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for temporary freezer. I Completion of the following table ma�w' ' .I. 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 Data Wiring: Heaters 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 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: WILLIAM C FLIGG Licensee: William C Fligg Signature LIC.NO.: 12584 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:55 FREEMAN RD,YARMOUTH PORT MA 026752304 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 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 L3ErciR Ca,am0,uu.a61 01 Keld6C 0Ii 6ry� �iPermit No. 2eparlmani of 3ira Seeeud Occupancy and Fee Checked MERD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (Invebimt) TION 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 PTy E LL IN4'QRMATION) Date:(0.-"j— Zt City or Town of: 1 }Y� To the Inspector of Wires: By this application the undersigned gives —i- Vice of his or herintention to perform the electrical work described below. GID Location(Street&Number) o (�� -` �'- toiS Owner or Tenant C:A v\u t� (//�y.ev-e,l \ZS Telephone No. Owner's Address � Is this permit in conjunction with a building permit? Yes ElE No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service(_,[C Amps (a.) /ZVU Volts Overhead❑ Undgrd[--No.of Meters / New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �)t,c kv-(Ur—4Qv✓y C...etx-t.( c.e-Q 2 z,--r Completion of the followingtable may be waived by the Inspector of Wires. vi Lb No.of Recessed Luminaires No.of Ceil:Sus (Paddle)Fans No.of Total P•ti Transformers KVA q No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting •t- No.of Luminaires Swimming Pool prod. 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 11i 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/Alertiny Devices No.of Dishwashers Space/Area Healing KW Local❑Municipal 0 Otbet• P g Connection No.of DryersHeating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent dromassa a Bathtubs No.of Motors Total HP Telecommunications Whin No.H Y g 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 Stan:Cii'—Z.i 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['BOND 0 OTHER 0 (Specify:) I certify,under the pains and penaltiesr.ofperl that the information on this application is true and complete. r� , FIRM NAME: ',�1 a,wt ln[ 1-cC 'r i C�ci,y�� /// LIC.NO.: IZSu I 15 Licensee: ‘ 41 Signature 6/ (/(/ A I LIC.NO.: C/ (If applicable,enter"exempt"in the license ber line.) Bus.Tel.No.•77ijtrxf(1 7 / 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)❑owner 0 owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.