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Home My WebLink AboutBLDE-22-002191 Commonwealth of Official Use Only �: , Massachusetts Permit No. BLDE-22-002191 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: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) 65 SPRINGER LN Owner or Tenant Bruce Prangley Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Chec r. x) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 i 6'SV.;%! New Service Amps Volts Overhead 0 Undgrd 0 ' o e Number of Feeders and Ampacity Q ✓ Location and Nature of Proposed Electrical Work: Replacement boiler&new split A/C. Completion of the following table mapw , ,1t,c n of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of otal // ` VA Transformers No.of Luminaire Outlets No.of Hot Tubs Generators VA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting-s grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 1 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 ❑ 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 I RECEIVED cr 1. OCT 15 2021C. - nw.JLe/!I/addaeiitw(ld {{OfficiiallIlseOnlyC� 1 ' v t/ c7 PctmitNoC�Z G L 1 j DINGDEPARTM• 14 nio/Jiee-Eonriced I l� :•'•• • PREVENTION REGULATIONOccupancy 1/ �and Fee Checked ' ( ) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 1‘ All work to be performed in accordance with the Massachusetts Electrical Code(MEC 527 C 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATTOM Date: /CS�/�-/ %\>J City or Town of: YARMOUTH To the Inspecetor o W By this application the undersigned gives notice of his or heriptention to perform the electri work described below. 1v Location(Street&Number) 6� S p rt ,)✓ f,�t A_ pi b'aiq C Yt Owner or Tenant Fj(- hone No. � q� -+l�l Owner's Address 5' { �y —/ ', Is this permit in conjunction with a/�uJ�J�i)�-¢'�permiit? Yes ❑ No l� (Check Appropriate B6� "4\ P, Purpose of Building �rt^)E [C/ Utility Authorization No. ^U Q Existing Service/ Amps f, 2f /.2Gftr Volts Overhead ED Undgrd❑ No.of Meters '� \( C New Service Amps / Volts Overhead Undgrd❑ No.of Meters 0 Number of Feeders and Ampacity )j(J 1/),o /p /jam el J /t 1 LA)1 t12.€ Location and Nature of Proposed Electrical Work: 'y //�' ® Completion of the followi"gtable may waived by the Infector of Wires. III No.of Recessed Luminaires No.of Cell-Seep.(Paddle)Fans r`o.of Total Transformers KVA .1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA Q _ 'k No.of Luminaires swimmingPool Above In- No.a Emergency Lighting �r•d. 0 t:rnd. � Battery Unite No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones T No.of Switches No.of Gas Burners No.of Detection and t Initiating Devices I I! No.of Ranges No.of Mr Cond. Total No.of Alerting Devices a Heat Pump Number.Tons _ KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other CYouuectiou No.of Dryers Heating Appliances KWS * No of Devices or Equivalent No.of Water No.of No.of Data Wiring: ICW Heaters Signs Ballasts No.of Devices or Elinivalent _ nsNo.Hydromassage Bathtubs No.of Motors Total HP Tel communicatNo.of Devices or Eqi ilvelent - ,OTHER: Attach additional detail if desired.or as required by the Inspector of Wirer. Estimated Value of El tric Work: 3 t (When required by municipal policy.) Work to Start: pinspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CC/�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 �perur(Na'of perjury,that theInformation on this application is true and complete./ �r p FIRM NAME: J`=+�C"+V'- o<.S/J .E=lG_� 7Z �/�, L1C.NO.:,./7/5 ,t-I 0 Licensee' UT s nerL�� Signature ,��/Ire' i..e °M --LIC.NO.: ?�0'// (If applicab e.enter'f em t'ipp the license num line.) /;1_ ,")I Bus.TeL No.' Address: S 7 /!l/' ti�i v`f-- �/f/ '1 AIL eL No.: � °Per M.G.L.c.147,s.57-61,seZ work requires Department of Public Safety"S"License: .11§... OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insuran&coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)[J owner ❑owner's agent. Owner/Agent I PERMIT FEE;$ Signature Telephone No.