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Home My WebLink AboutBLDE-23-004399 i CAin) Commonwealth ofOfficial Use Only % 1, Massachusetts Permit No. BLDE-23-004399 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 6 L£l E=23 -6Sr 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 800 Amps Volts Overhead 0 Undgrd El No.of Meters / Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Rewire as needed &replace service.(MAIN BLDG.) 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 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 Initiating Devices No.of Ranges No.of Air Cond. Tonal 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 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 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) owner 0 o ner's ,gent. ,6! Owner/Agent � ��J�-�_(/ Signature / Telephone No. PERMIT FEE: $905.00 —rr l�s(�--cmp : Qx/V > `I li(23 ci W.t ,ty u,rs T K Pg$ 1 ittslZs r,4 trl 51-pdia 6/iy/zy 734-65 1-66 6-ArjrCcx.-"s10t'7 .4-62 Lc(rE 046c7 C `i(2,1.2,s ez P0111 kg 06 c, k -) \,)--zxk Ur., i VA0l Uta—c.s,T.Gc� tat►- � 2'42-4 tu4, d,y��W ia- , RECEIVE ® Alb.- Commonwealth. o/Masrachuesffe Official Use Only Mori ,t a 03 2023 cc77 0Permit No. 'w ,sparfmsnt°I irs ` r'ic,sse .% /1• , F 117 , i.i' l Occupancy and Fee Checked '•' `' '` ' A 1 PREVENTION REGULATIONS Rev. 1/07 ' �''' leave blank ------ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perfonned in accordance with the Massachusetts Electrical Code(MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Z 2 ci i 3 City or Town of: YA R M O U T H To the Ins ecto of Wires By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 1'5 f -I- . Owner or Tenant Lot p i' (_c,rk ( ) 1()I 00 X Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes � No ❑ (Check Appropriate Box) Purpose of Building C o M'Nem' ¶ r t C:\ Utility Authorization No. Existing Service Amps / Volts Overhead U Undgrd No. of Meters New Service E) ) Amps i i > > ❑ Undgrd t P 1 t.. /�� G Volts Overhead Und rd x Na. of Meters Number of Feeders and Ampacity Li - ri (`.e Or% A i 7 Location and Nature of Proposed Electrical Work: ci t vi Completion of the followin table may be waived by the Inspector of Wires. (ii. No. of Recessed Luminaires No. of Ceil:Susp. (Paddle) Fans No. of Total ivTransformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA Wit" No. of Luminaires Swimming Pool Above ❑ In- ❑ No. of Emergency Lighting �rnd. rnd. Battery Units _ `} No. of Receptacle Outlets No. of Oil Burners T--- FIRE ALARMS No, of Zones -1, No. of Switches No. of Gas Burners 'No. of Detection and Initial`_ ng Devices i 1 ' Nu. of Ranges No. of Air Cond. 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 Local ❑ MConnection rr Other �` Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Water No. of Devices or Equivalent No. of No.of Data Wiring: Heaters 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 of Electrical Work: 1 S C 6; L.) , .` (When required by municipal policy.) Work to Start:2 i 3 _ Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE OV RAGE: Unless waived bythe owner, no permit p rmit 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 ❑ (Specify:) I certify, under the pains and penalties of per'ury, that the information on this application is true and complete. FIRM NAME: �04Ai , NiunJc 0(cJ l " satyr (,.,L( ti Licensee: T o r� Ma r`. r� !t:- Signature 2JI /!A lC. NO.: - Z0�, ( C (If applicable, enter "exempt"in fife license number line. g v�` �t` LIC. NO.: - ,U l� line.) Bus. Tel. No.:' -C.* 7 )C - Address: CA ; r`l\ ofV-ceC 0r. - Ellaitetp ef- / C ? 6 eici 1�1>b} 1 I .s'� �� *Per M.G.L. c. 14T, s. 57-61, security work requires Department of Public SafetyAlt. Tel. No.: .. License: Lic. No. 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 his requirement. I am the (check one owner owner's a ent. Owner/Agent Signature Telephone No. PERMIT FE'E'l. $