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Home My WebLink AboutBlde-18-006994 Commonwealth of Official Use Only OM Permit No. BLDE-18-006994 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:6/11/2018 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) 277 SOUTH SHORE DR Owner or Tenant THE 277 SOUTH SHORE DR LLC Telephone No. Owner's Address PO BOX 370, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ai riate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 o. e , . . New Service Amps Volts Overhead 0 Undgrd 0 inFAVW Number of Feeders and Ampacity I r/'r Location and Nature of Proposed Electrical Work: Roof top air conditioners. I U O Completion of the following table may be waiv t , r, •f Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of I tt Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ElNo.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. 17 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 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 Data Wiring: Heaters Siens 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: WILLIAM L WOLASZEK Licensee: William L Wolaszek Signature LIC.NO.: 28768 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:96 CAPTAIN LOTHROP RD,S YARMOUTH MA 026642818 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:$400.00 4 Commonwsaith.of masaachadeltt Official Use Only is=* . - �i -1 Apartment o f emirs S' Permit No. `-1 �-- q L� _ _ /� Serviced -1-; = 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 accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his o� 1 r;,her intention to perform the electrical work described below. 'g I • Location(Street&Number) a -7 7 S 0, T , S h o'e 1V-6 r,.-e U{ F Q 5GYt c9 As LP POwner or Tenant S 6 v•� S t''Le D c /_Lc Telephone No. �\\"J Owner's Address .7 7-7 S o,,.�,, Sl„,,, ' ..t ,� `7 Is this permit in conjunction with a building permit? Yes El No 21 (Check Appropriate Box) JJ Purpose of Building Utility Authorization No. -- ." n 'Existing Service Amps / Volts Overhead ❑. Undgrd❑ No.of Meters 1 New: _Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters .,� Number of Feeders and Ampacity •-v Location and Nature of Proposed Electrical Work: (7,1h �oo� C�►�c 1C J 7 Cancl21•,sot U »,�s ' Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell-Susp (Paddle)Fans No.of Total Imo_.(9 . Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No:of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. trod. 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. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump 'NnmberiTons KW No.of Self-Contained Totals: Detection/AlertingDevices No.of Dishwashers Space/Area HeatingKWMunicipal Local❑ Connection ❑ � No.of Dryers Heating Appliances , Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of 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 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 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: (A);11ic1,c.. L„o1 e.S7-c LIC.NO.: Licensee: Uj,`l i c►� (J.) 0/457-..Qi Signature C t---2.ei(If applicable, enter"exempt"in the license number line.) LIC.NO.: Address: 96 C e,f fe r,, L u*'L r v�l� L Bus.Tel.No.: SO__$i�� 65Sc� J *Per M.G.L. c. 147,s.57-61,security work requires Department of Publicc Safety"S"License: Lic. No.Alt.Tel.No.:• ,,r OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner 7 Owner/Agent0 owner's a ent ISignature Telephone No. PERMIT FEE: $ 5Q -I C ( ) TR(24.5 uati_ rctrov2. ovoutir, (JJ c4g-f" dziO 6.674//ct`g ay ( --to (c_) 3 t ti7W x-60 c-T-0 73 C t--L) in 04/ 61/1 UlL01/2-11 -,