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HomeMy WebLinkAboutBLDE-19-002391 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-002391 ' 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 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:10/22/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertonu the de 'al work cscriibbedbelow. . V Location(Street&Number) 29 LEWIS BAY BLVD UNIT 10 / /V e 1 / v// A-etWA-et-- Owner A-eL-Owner or Tenant CC HOLDINGS LW "telephone No. Owner's Address C/O ARTHUR MANSELIAN, PO BOX 14, SOUTH YARMOUTH,MA 02664 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: On-demand water heater. 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 0 In- CINo.of Emergency Lighting grad. grad. 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 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water 1 KW 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: (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 El (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: EDWARD M LYNCH Licensee: Edward M Lynch Signature LTC.NO.: 35609 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 WIDGEON LN,WEST YARMOUTH MA 026733818 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 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 ci& V cc0/3oRe r ..,.. ammo. ofc/7r/ws�asc ifs Offciiall Use On1n rV{ �. 1JsParfmsnE oi.Yirr Jsroiut • Permit No. MI—2.....n`- BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ev. l/07] (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 7 . 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: (/f; City or Town of: YARMOUTH To the Inspect° of W, es: 0 By this application the undersigned gives noti of his or her int t••n to perfol; eel- • cal work . s below. • . Location (Street&Number) erg r t Lif f• / • Owner•orTenant mit, f a.e -I44114 l� ' �1 1 Telephone No. Owner's Address Is this permit in conjunction with a building permit? YesNo ❑ •, ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No, Existing Service Amps / Volts Overhead❑, Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No,of Meters Number of Feeders and Ampacity 0 cktion and Ndture of Proposed Electrical Work: © r G/ Wfilar Th1? 7 1 I" w W m 1~ I Co ..lesion o the ollowin. table . be waived. the I .- Toro Wirer. 7 I all of Recessed Luminaires No.of CeIL-Susp.(Paddle)Fans 'o.o Total Transformers TVA IIS Cil Mo . .f Luminaire Outlets No.of Hot Tubs Generators KVA t7 V U Bo.I•f Luminaires SwimmingPool Above 0In- No.of Emergency lighting W Otrrnd. gird. Battery Units t.... i f Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones • • 4 f Switches No.of Gas BurnersNo.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local 0 Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water o of No.of Devices or Equivalent Heaters No.of Data Wiring: Sips 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‘desired or ar required by the Inspector of Wires. Estimated Value of Electrical Work (When required by municipal policy.) Work to Start Inspections 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 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 NAM LIC.NO.: Licensee: _4 ffei di(' I / / i it, Signature I i' �rr LIC.NO. (If Address: r e e r 'i i.�'Ir r be fine.+ , Bus.Tel.No.' Addresr. � i / /l. �dfl� /J Alt.Tel.No.: -4 _7 .�9?Q j Per M.G.L.c. 147,s.57 61,security work requires epartment • Pah a Sa ety" "License: Lic.No. (1 Ili— OWNER'S INSURANCE WAIVER: I am aware at the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. !am the(check one 0 owner 0 owner's a�- t Owner/Agent a Signature Telephone No. PERMIT FEE:S 5 D��