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Home My WebLink AboutBLDE-22-005802 r Commonwealth of Official Use Only 0�. Massachusetts Permit No. BLDE-22-005802 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:4/11/2022 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) 362 WILLOW ST Owner or Tenant COMMONWEALTH OF MASS Telephone No. Owner's Address 1 ASHBURTON PLACE,BOSTON,MA 02108 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appp�rjate Box) Purpose of Building Utility Authorization No. C//`O/1^^ Existing Service Amps Volts Overhead 0 Undgrd 0 o.of"'�Y° ?/..7 New Service Amps Volts Overhead 0 Undgrd 0 1".''y_fl°� Number of Feeders and Ampacity `�4<./2 Location and Nature of Proposed Electrical Work: Adding to Existing Security System w Completion of the following table Ihs or of Wires. 1No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of fiotal Transformers , `�`• A No.of Luminaire Outlets No.of Hot Tubs Generators / �* A No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. grad. 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. 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 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* 17 No.of Devices or Eauivalent No.of Water KN No.of No.of Ballasts Data Wiring: Heaters Sit'ns No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent OTHER: Attach additional detail ifdesired.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: Richard L Sampson Licensee: Richard L Sampson Signature LIC.NO.: 502 (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:$115.00 1 Cmunonweatth. n`rilaMatitudeth Official Use Only *- O Z=Mbilii t cX c7 Permit No. E^ )2 2.^ 6 ---e 7----. -4 - _ ,�=V apartin�ad o` ire Serviced me i Occupancy and Fee Checked m c - BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07 ( blank) rlik IT1 �. leave ° APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 _I (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 4/6/2022 42 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. y Location (Street & Number) 362 WILLOW ST ID ID Owner or Tenant MASS DOT Telephone No. n COwner's Address Is this permit in conjunction with a building permit? Yes ❑ No 2 (Check Appropriate Box) o Purpose of Building Utility Authorization No. CTc' Existing Service Amps / Volts Overhead Eli LJ Undgrd 1 I No. of Meters 0 o. • New Service Amps / Volts Overhead ❑ Undgrd No. of Meters a • r— Number of Feeders and Ampacity Q Location and Nature of Proposed Electrical Work: ADDING TO EXISTING SECURITY SYSTEM .p 0 Cr cn (D .0.) Completion of the following table may be waived by the Inspector of Wires. r No. of Recessed Luminaires No. of Ceil.-Sus (Paddle) FansNo. of Total o p' - I Transformers KVA -0 0 No. of Luminaire Outlets No. of Hot Tubs Generators KVA �. * Above In- No. of Emergency Lighting p No. of Luminaires Swimming Pool ❑ ❑ CD grnd. grnd. Battery Units = F/3• No. of Receptacle Outlets No. of Oil Burners (FIRE ALARMS No. of Zones o No. of Detection and o No. of Switches No. of Gas Burners Initiating Devices -0 Total crn No. of Ranges No. of Air Cond. Tons No. of Alerting Devices CD Heat Pump Number Tons KW No. of Self-Contained No. of Waste Disposers Totals: Detection/Alerting Devices Municipal No. of Dishwashers Space/Area Heating KW Local ❑ ❑ Other • Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent 17 No. of Water KW No. of No. of Data Wiring: Heaters _ Signs Ballasts No. of Devices or Equivalent No. Ilydrornassage Bathtubs N0. 09' Motors Total IiP 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: $10000.00 (When required by municipal policy.) Work to Start: 4/11/2022 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 ❑ OTHER El (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: American Alarm & Communications, Inc. LIC. NO.: 1 2 1 2 C MA Licensee: Richard L . Sampson , S r . Signature r~, LIC. NO.: 5 0 2 D (If applicable, enter "exempt" in the license number line.) - c Bus. Tel. No.: 781-641-2000 Address: 297 Broadway , Arlington , MA 02474 r`�- .• 1-' ) Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. SS CO 000090 MA 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 PERMIT FEE: Signature Telephone No. $ 115.00 r