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Home My WebLink AboutBlde-22-001725 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-001725 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:9/27/2021 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 bel Location(Street&Number) 12 MOHEGAN LN PAL( _. („L!za Owner or Tenant Telephone No. Owner's Address C/ _ - :- - , _== "'" • , _ ... „_ 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: Miscl.work per attached. 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 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 ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs 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 my 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:$50.00 101 tip Commanwsa[th of 7addac�iudetta Official Use Only s•es ( J`y \ i 25� �'/ n ,_..- Permit No. E -..,a,;q ti spartmsrd o .. Ira Jsrvicsd . ..'I`,"' '' �BOARD OF FIRE PREVENTION REGULATIONS [ReOcv.0 and Fee la{leave blank)ked nk) , ' 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 this application the undersigned gives notRMhOUTHtention to perrfooTormethen electrical workdector of s Wires: below. Location(Street&Number) )Z neLtl L+y 400.. ( c - c t i) Owner or TenantAliL L / , VA fir. .- ,r f //o Telephone No j — L `1 Owner's Address „ 5�.� i Is this permit in conjunction with a building permit? Yes 0 No� (Check Appropriate Box) Purpose of Building 4 J, gl ..I e.& Utility Authorization No. Existing Service/l Amps / Volts Overhead❑ Undgrd❑ No.of Meters v� New Service Amps / Volts Overhead `.Y ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity 4 t4 v to D (-' ,4„) Location and Nature of Proposed Electrical Work: \ .Sul�'.rrr•/ 1 c✓ -�w k mac.... L,.••... T✓ �L,l.a .. "c )t (40,1„144.,04,.�Q/t L,11.44) vi• /'�,r•0✓� tu•'4 r�.�t.�LL....[./..� aJ77w)) W,i�� fo �. �B: �7s- Completion of thefollowingtable may be waived by the In ec�tor of Wires. Ui' No.of Recessed Luminaires No.of Cell.-Sus No.of Total p.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA t" 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 INo.of Zones '` No.of Switches No.of Gas Burners 'No.of Detection and t~' No.of Ran es 'total Initiating Devices g No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump 1 Number'Tons1 KW 'No.of Self-Contained Totals: "l[ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Oiber No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent Heaters KW 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: N! Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lectrical Work: tf )4 (When required by municipal policy.) Work to Start: 7.W Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE 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. ECK ONE: INSURANCE- BOND 0 OTHER 0 (Specify:) ® r I rtlfy,under the pat s and penalties of perjury,that the lnf matlon on this application is true and complete. ��.�H FP' NAME: v / a le ' LIC.NO.. Liji _ z Li ensee: /ftv/ ,. . Signatureiz(If pplicable, r"exem t"}`n the li ense number line.)• i• �^r LIC.NO. "` , , :,A' ress: ,� f,y. /f Li Bus.Tel.No/t. v 6( 3/ �? *P r M.G.L.d. 147,s.57-61,security work requires D��, Public afety"S"License: Alt.LiTe.No. ` 0 0... .O NER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally t W ,ceq 'red by law. By my signature below,I hereby waive this requirement. I am the(check one)0owner 0 owner's agent. .{•i ' CI) er/Agent r� ,®..,.._.®—.s 1$ store Telephone No. I PERMIT FEE:$ 501 cA,C