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HomeMy WebLinkAboutBlde-19-007266 or c tr) Commonwealth of Official Use Only
�, Massachusetts Permit No. BLDE-19-007266
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:6/26/2019
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) 50 WILSON RD
Owner or Tenant ECKERT ROBERT M Telephone No.
Owner's Address ECKERT GLENN S,50 WILSON RD,WEST YARMOUTH, MA 02673
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 ❑ Undgrd 0 No.of Meters
New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Remodel&add bathroom.
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
Initiatine 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 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 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 0 (Specify:)
I certify,under the pains and penalties ofperjuty,that the information on this application is true and complete.
FIRM NAME: EDWARD M LYNCH
Licensee: Edward M Lynch Signature LIC.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: $75.00
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C.ommoruvidth of//Jasdar Official Use
al' c�
Permit No. —1
C) =�_._ r 2eparinzeni o{.c�777ire Services
en f BOARD OF FIRE PREVENTION REGULATIONS Occ
1/0�'and Fee Checked
(leave blank)
APPLICATION FOR°PERMIT TO PERFORM
Lu ev Z All work to be performed in accordance with the MassachusettsEL(M EC52 12 WORK
U o(,•LEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:
Lu City or Town of:
°' Y�MOU� To the Inspect�ir o ' es:
t 1� this application the undersigned ' es not; of his or her' lion t perform the electrical wo described below.
cation (Street&N be )
Owner or Tenant 0 O
r
1� G Telephone No.
Owner's Address5' ,L
Is this permit in conjunppjo`n with,a uiiding permit? Yes No
Purpose of Building ��vv w VV l/ [I] (Check Appropriate Box)
�� Utility Authorization No.
Existing Service Amps Volts Overhead
❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undg
rd ❑ No,of Meters
Number of Feeders and Ampacity
Locatio/nAnd Nature of Pro osed Electrical Work: /f e 9qj *TC24 / / ?
pfrqo 4 q (
Completion of the followingtable may be waived by the Inspector o FPrres,
No.of Recessed Luminaires No.of Ced.-Susp.(Paddle)Fans No.of Total
Transformers KVA
No. of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimmin Pool Above In- No.of ht mergency lghun
g arid. Qrnd. Battery units g
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS JNo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
Total
No.of Ranges Na. of Air Cond. Tons 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 L°cal❑ Municipal
Connection ❑ Outer
No.of Dryers Heating Appliances , Security Systems:*
No.of Devices or Equivalent
No.of Water No.of
Heaters ' 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 lectric Work
! (When required by municipal policy.)
Work to Start: b Inspections to be re
quested� in accordance with MEC Rule 10,and upon completion.
INSURANCE C 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 coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE 1 BOND ❑ OTHER ❑ (Specify:)
I certify, under the pains and penalties of perjur37,that the informatia on this application is true and complete.
FIRM NA
Licensee: �' C � � LIC.NO.:
L applicable ( Signature 4,61/00 ireLIC.NO.: p
f PP ' empt' in the i erase ber line.) s.Tel.No.: ?le
. Address. It.Tel.No.:
j `Per M.G.L.c. 147,s. 7-61,security work requires Departm of is Sa ty"S Lic Lic.No.
OWNER'S INSURANCE WAIVER I am aware that the L censee 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)0 owner 0 owner's agent
S
Owner/Agent
I Signature Telephone No. [PERMIT FEE: $
'Y1 TOWN OF YARMOUTH
./k ' - 40 BUILDING DEPARTMENT
o y 1146 Route 28, South Yarmouth, MA 02664
MATTA ESE 508-398-2231 ext. 1263 Fax 508-398-0836
K. Elliott, Inspector of Wires
kelliott(a,yarmouth.ma.us
September 18,2019
Edward Lynch
25 Widgeon Lane
West Yarmouth, MA 02673-3818
Location: R. Eckert, 50 Wilson Road,West Yarmouth
Permit Number: BLDE-19-007266
Dear Mike;
The above noted location inspection failed to pass for the reason(s) listed.
Article 210-8 (Fan over bathtub to be
GFCI protected.)
Article 406-12 Receptacle to be tamper
resistant.
Please forward the required re-inspection fee of eighty dollars ($80.00) to this office and
advise when the corrections have been made and when access may be gained, to the property,
for the re-inspection.
If you have any questions please do not hesitate to contact me.
Sincerely,
Town of Yarmouth, Building Department
K. Elliott,
Inspector of Wires