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Home My WebLink AboutBlde-20-003242 E4\o„ Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-003242 jay 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:12/6/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 307 OLD MAIN ST Owner or Tenant CULTURAL CENTER OF CAPE COD INC Telephone No. Owner's Address P 0 BOX 118, 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 CI Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install receptacle. 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 1 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/Alertinc 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 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 ❑ BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjuty,that the information on this application is true and complete. FIRM NAME: Paul M Ryder Licensee: Paul M Ryder Signature LIC.NO.: 39762 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:210 WESTWIND CIR, OSTERVILLE MA 026551366 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: $80.00 ( kUC ( ct J Y R. am+noaunsaUh o ao --- ///M �Susaff! Official Use Only 1t11 c� inl ' 1Jepariment o f Sere Permit No. �/� �/ • - BOARD OF FIRE PREVENTION REGULATIONS I Oc v.a�• and Fee Checked eave 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: YAR1VIOUTH To the I ect r of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. • Location(Street&Number) 7 0 c/ .i T .Tv,•7tZ Owner'or Tenant e. t Cep C /,vao/ Owner's Address Cs...„ Telephone No. °f' ty . 7/� Is this permit in conjunction with a building permit? Yes ❑ Nu (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 Location and Nature f Proposed Electrical Work: /, /Z-0 V 9 1:o A'Avg, ;4Ac i ,u pl�on o7the folltnvinvable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell-S • addle Fans No.of Total ) Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires swimmingAbove in- No.of emergency Lighten pool =mod- ❑ �rnd. 0 Battery Units g Na.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas Burners 'No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total , Totes 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❑ Municipal Connection ❑ Outer No.of Dryers Heating Appliances KW 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: OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work /► Attach additional detail if desired or as required by the Inspector of Wires. �a 0 (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO GE: 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: INSURANC OP2 BOND ❑ OTHER ❑ (Specify-) I certify, under the pazr;C�and paucities e perjury,�j that the information on this application is true and complete. FIRM NAME: �r 21.—Licensee: �yLIC.NO.: Signature LIC.NO (7fapplicable,a er�t in he license number t • 3, Address: „ '�/s .c //2./ � �,41� • Bus.TeL No.• l `Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety _ Alt.TeL No. �/ OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilityLin.No. insurance coverage n — S required by law. By my signature bolo I h r y wai a is rement I am the(check one owner o Owner/Agent c j�,_? ,� (,� )❑ ❑ wner's aeenr i Signature v( /