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HomeMy WebLinkAboutBlde-21-006501 -�.....►._ Commonwealth of Official Use Only ifE Massachusetts Permit No. BLDE-21-006501 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:5/10/2021 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) 8 MOHEGAN LN Owner or Tenant CASS WILLIAM E LIFE EST Telephone No. Owner's Address CASS PATRICIA A, 8 MOHEGAN LN,YARMOUTH PORT, MA 02675-2445 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 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Split A/C system 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. 1 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 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 of perjury,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: $50.00 Ckl, A(k tv rr, t,on onwis _`MassacItuddis Official Use Only n �� ( 'l �epartnE o/.fin JirvicRt Permit No. (h ' �(J _� I j ,' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYP ALL INFORMATION) Date: 1 7 City or Town of: A.i'/+^ 14 Ti.. To the ns ctor Wires: By this application the undersigned ves notice of his or her intention to perform the electrical work described below. Location(Street&Number) Q �j to 4,t,�a,,.. /a..NA ( ii0 .-/- Owner or Tenant �i.// C d JJ Telephone Nara$) fit 7 - Owner's Address ._14w..a. J-141Y Is this permit in conjunction with a building permit? Yes ❑ No 12] (Check Appropriate Box) Purpose of Building /.c,,f:.(,...c...t. Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters I New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity . Location and Nature of Proposed Electrical Work: IA,)t re„ G--s..•1$J C. . A..— , �, , Jr,I Ps✓1 tA- / .,I. /(1 t ,<> 6-- , 4- ./1-d Completion of the followin&table may be waived by the Inspector of Wires. N of No.of Recessed Luminaires No.of CeiL-Sus P•(Paddle)FansTransTotal TTrsformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmin Pool Above ❑ In- ❑ No.of Emergency Lighting g arnd. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of No.of Switches No.of Gas Burners No. InDete and Initiatinnggon Devices No.of Ranges No.of Air Cond. ) Totals I No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 1 Totals: Detection/AlertingDevices Municipal No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other No.of Dryers Heating Appliances KW N Securityy 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 HI' TelecommunicationsNofDevices or Wiring: Na of Devices or Equivalent OTHER: ,o, Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: Ya V (When required by municipal policy.) Work to Starts f-• 2- 2.1 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 tgr BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of pedury,tkat he information on this application is true and complete FIRM NAME: ,/t € 11, ..../ �/tv/ A iev�- LIC.NO.: Licensee: ',,iv/ A .,.r Signature LIC.NO.• (If applicabl ,enter "exempt' in the license number line.), Bus.TeL Nq.�•/..24 -, al.Address: A c . f6vo4- //1. / 0J1 c-v1 �/s. Alt.TeL NV " *Per M.G.I/'c. 147,s.57-61,security work requires Department of Public Safety"S"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 this requirement. I am the(check one)❑owner El owner's agent. Owner/Agent Signature Telephone No. 1 PERMIT FEE: $ p • • ..� ! , t pa',. ,d 4 t •0 n 411 .• a • • . ' . .