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Home My WebLink AboutBLDE-22-003299 d Commonwealth of Official Use Only 1164\ Massachusetts Permit No. BLDE-22-003299 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR (2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:12/10/2021 _ 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) 960 ROUTE 6A Owner or Tenant ORMON BROTHERS REALTY TRUST Telephone No. Owner's Address M DALE ORMON TR, 27 FARM HILL RD, DENNIS, MA 02638-2454 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No. et rs Number of Feeders and Ampacity /j Location and Nature of Proposed Electrical Work: Install controls for lighting&power for sound equipment & e 16�r alarm system. V Completion of the following table may be waive 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 Initiatine 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/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: STANLEY H BULLARD Licensee: Stanley H Bullard Signature LIC.NO.: 39163 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 103, ORLEANS MA 026530103 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: $100.00 Commonwealth.o/Madded...A Official Use Only Permit No. t---tz—,zcid9 2eparimind oi e..garvicss .: 4,11.1„:, I Occupancy and Fee Checked ' BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in acconlance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 . (PLEASE PRMT IN INK OR TYPE ALL INFORMATIO1V) Date: i is/aq I City or Town of: YARMOUTH To the In pea r of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) FZA,X(1 umAT cl 6 0\fluo-AA<frAszcl- Owner or Tenant Telephone No. 36?—in ry„2_ Owner's Address Is this permit in conjunction with a building permit? Yes E] No.g1;) (Check Appropriate Box) Purpose of Building IFLQ.4.tu j,,Lek,h-r- Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd[j No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters _ _- Number of Feeders and Ampadty . , i Location and Nature of Proposed Electrical Work: ' I ' ,, MAAS rruliaa. Fez t A i..)v•e_AIA.4)....6;ta-- ' . ici Completion of the follow &table mT,be um' cvilbspector of Wires. •sie No.of 'I otal Li! No.of Recessed Luminaires No.of CelL-Susp.(Paddle)Fans Transformers KVA .,./ ..„ C.'‘ No.of Luminaire Outlets No.of Hot Tubs Generators KVA KZ1 1 Above r-i In- ri N o.ot Emergency Lighting 4• No.of Luminaires Swimming Pool grnd. ,--, grnd. 1-1 Battery Units "..,! No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones -, No.of Detection and •••-•-•- No.of Switches No.of Gas Burners Initiating Devices i oral It' No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 'Heat Pump!Number[Tons [KW No.of Self-Contained No.of Waste Disposers Totals:I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 'i l'counnnicecilitaon 0°tiler No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of KW Data Wiring: Heaters Sips Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent pOTHERS I Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of E Meal Work: (When required by municipal policy.) Work to Start: q Inspections lobe requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO E: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.4a,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: LIC.NO.: Licensee:(If applicable,enter"exempt"in the license number B line.) 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 I101 have the liability insurance coverage normally required bylaw. By my signature below,I hereby waive this requirement. I am the(check one)Downer 0 owner's agent. Owner/Agent Signature Telephone No, I PERMIT FEE:$ I