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Home My WebLink AboutBLDE-23-004401 Commonwealth of Official Use Only Aat 23 -‘9 �. Massachusetts Permit No. BLDE-23-004401 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:2/8/2023 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) 125 ROUTE 6A Owner or Tenant CAPE COD UROLOGY ASSOCIATES Telephone No. Owner's Address 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 200 Amps Volts Overhead 0 Undgrd El No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wire office building Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of /fotul 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 No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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 Signs 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: JOHN R MANGOLD Licensee: John R Mangold Signature LIC.NO.: 20311 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:9 SPINNAKER DR, MASHPEE MA 026493655 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: $395.00 e tet, „ ?Lt)ci o (/23(Z3 444 gi • (E tNicti A Cc oul r lib liw c; 7�31,5 / d3 rtmcvt.066146 (31,0.c.ortAAO lhaet,4 CaMul,i Tea/ SI7Zd (.r 7/2z q. j t Lit RECEIVED FEB 0 3 202io seta o f///aedachuo.ttd Official Use Only ' Permit No. - DING ' ' aE o1,}iin "ilk d •-• �a+.._ � UcNARTM -N e Iv 1 i Occupancy and Fee Checked J ` = • ' - % = - 'REVENTION REGULATIONS [Rev. 1/07] (leave blank) 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: 'L/ .3 1 G13 City or Town of: YARMOUTH To the Inspector(, Z Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work describedbelo . Location (Street& Number) `• - Q}. 6 \ (Ji,^- tr\o5\cut k d r V c 11 e G Owner or Tenant C N cp P � C, (`o\03�!" Telephone No. Owner's Address J Is this permit in conjunction with a building permit? Yes L4 No ❑ (Check Appropriate Box) Purpose of Building Co mn.rveCt C 1 Gt \ Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service 2 00 Amps I I 0 / 2ob Volts Overhead ❑ Undgrd No. of Meters _ Number of Feeders and Ampadty L4 —IN t C f — Z >, pi M . , Location and Nature of Proposed Electrical Work: N\,;:,, K.:v.. ;}Ac)._\�, 0 eN o 1 t cLx 6 os vi . Completion of the followingtable may be waived by the Inspector of Wires. tb No. of Recessed Luminaires No.of Ceil.-Snsp.(Paddle) FansN f 'Total "I T Trr anosformers KVA nNo.of Luminaire Outlets No.of Hot Tubs Generators KVA No. of Luminaires pool swimmingAbove In- No.of Emergency Lighting grnd. ❑ grnd. ❑ Battery Units `) No. of Receptacle Outlets No.of OU Burners FIRE ALARMS No. of Zones No. of Detection and No. of Switches Na.of Gas Burners Initiating Devices Ranges No.of Mr Cond. Total t 1-1 No.of Ran ti Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number_Tons.•._._ KW 'No. of Self-Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW "'❑ Municipal ❑ Other ' Connection No. of Dryers Heating Appliances KW Security No yf Devices or Equivalent No. of Water No.of No.of KW Heaters Data Wiring: 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 o Electrical Work:30, 000, (When required by municipal policy.) Work to Start: Z. 7 0 3 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE 0 RAGE: 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 c�ov a is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE L� 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: 10 .A(`, 1 '1 u I';, F4 rz t ecfric LIC. NO.: ( - 7 o 3 ii Licensee:,To4i(\, MCM\,{ o t Signature 4/14,4 LIC. NO.: ` 570 i 5-- (If applicable ent "exempt"in`7he lie a number line.) � Bus. Tel. No.: Address: 1 _ 7.P;c4vi - *Per M.G.L. ' ��• �'�v-t'_ - � � U�'(��f Alt. Tel. No.: ,,S_'D.�'. 7�` q -I S G.L. c. 147, s. 57-61, security work requires Department of Public Safety"S" License: Lic. No. a� 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 Signature Telephone No. I PERMIT FEE: $ 646-----l