The URL can be used to link to this page

Home My WebLink AboutBLDE-22-002193 ;,. r.- Commonwealth of Official Use Only • Massachusetts Permit No. BLDE-22-002193 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 Codc (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:10/18/2021 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) 24 OLIVER ST Owner or Tenant COTTER WILLIAM F Telephone No. Owner's Address 24 OLIVER ST, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (C • • ' • : e Box) Purpose of Building Utility Authorization N Existing Service Amps Volts Overhead 0 Undgrd 0 olW A New Service Amps Volts Overhead 0 Undgrd 0 . 8 • • Number of Feeders and Ampacity D Location and Nature of Proposed Electrical Work: Air condition system. � 40 Completion of the following tkb b• , i i h ctor of Wires. 4At No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of � Total Transformers O 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 Initiatine Devices No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: 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: GARY L GORDON Licensee: Gary L Gordon Signature LIC.NO.: 15290 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:37 BILLINGSGATE DR, DENNIS MA 026382234 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: $50.00 4 - �J RECEIVED �, OCT 15 2021/� Massachusetts Comm°samosa a/rt/assachusetts Otticial Use Only ��LH' y *1 DING DEPARTMLr�aT^-tY-nt a/c7 ire �ie�ked Pemut No. �2z-�� 15 v a° Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 'Rev.1/07] (leave blank) APPLICIATIIONl work to be PFORerformed t PERMITn dance TO PER the FEORM ELECTRICAL WORK A(PLEASE PRINT IN INK OR TYPE ALL INFORMATION] Date: /C)lectrical Code //r l2/ \`, City or Town of: YARMOUTH To the Inspector of Wires: V By this application the undersigned give notice frhis or her inters on to perform the electrical work described below. v Location(Street&Number) 0 4//pie t g o,-,? Owner or Tenant 5. p ('�'2 Telephone No. Owner's Address 1\. St Ia this permit In coniunctionpith ldisig permit? Yes ❑ No ❑ (Check Appropriate Box) VI Purpose of Building l l i'fUtility Authorization No. b Existing Service/QD Amps /16/ i1.d Volts Overhead a Undgrd❑ No.of Meters Q C New Service Amps / Volts Overhea ❑ Undgrd No.of Meters 0 Number of Feeders and Ampacity /�f. t7� 1 ./A— /C �„..c Location and Nature of Propoaae��+El 1 Work• • ' / Completion of thefollowing table may be waived by the inspector of Wires. obit lb No.of Recessed Luminaires No.of CeU.-Soap.(Paddle) Tr Fans Tra ns 1esformTransformers KVA VA \ T/ n No.of Luminaire Outlets No.of Hot Tubs Generators KVA d• No.of Luminaires Swimmiu Pool_r Above In- No.of Emergency Lighting g ots. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of OU Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners -No.of Detection and . Initiating Devices II.' No.of Ranges No.of Air Cond. Toni No.of Alerting Devices Na of Waste Dbpours 'Heat Pump Number Tons,_.KW_._. No.of Self-Contained Totals: "' - . Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW "cal 0 CoMunicipalioo Other omnoect Na of Dryers Heating Appliances Kµ Security Systems:* No.of Devices or Equivalent 'No.of Water No.of No.of HeatersData .of e: Signs Ballasts Na of Devices or Equivalent No.Hydromaaaage 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 lectric Work: �7 /-3 i (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule I0,and upon completion. INSURANCE C E:Unless waived by the owner,no petmit 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:) certify,under the pains and penalties off�eerf.u1ry`,thratt thyinformation on this application is true and complete.�. FIRM NAME: �opeaKeAJaf..1p1.)S•G ?rc �� LIC.NO.:� ° Licensee: Grjf..04,.� Signature -LIC.NO.:�S 44% (If applicable,enter" m t"in the lic a num line.) t- Addrna:.3J ,/� i o d ye �e/✓X/J Bus.Tel No.s .... Per M.G.L.c.147,s.57�61,fccuri workDepartment / Alt.Tel.No.: L/� ty requires ofPublic Safety"S"License: Lic.No. `t!� / 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 0 owner's agent. Owner/Agent Signature Telephone No. 1 PERMIT FEE:$