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Home My WebLink AboutBlde-21-005679 Q Commonwealth of Official Use Only filPitTh — , Massachusetts Permit No. BLDE-21-005679 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:3/31/2021 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) 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 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: Repairs to roof top A/C equipment and install receptacles. 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 Initiating 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 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 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $400.00 NSIA {(u( ' g4 Commonwsa[th of///addachudsttd Official Use Onl ''�':ii t cc77 C� Permit No. 1 '" S(79 e �: ti sparimsnt o�.}irs Serviced -.11 < 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( EC),5 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 3/31J /a-\ 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) a' )"7 SG u' c,y,- )\,.Q Owner or Tenant Su C (= q,.. SGh G _.,/V1 J 1""c-V Telephone No.S'ag 3 tc' 3 70() Owner's Address -7 'j So-" Sin t,re ,p c 0.4. Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electricall Work: e P4 is I Lk) c 1N., -1-•O p h o o P .rue U ►--1 - S`tic, I ( fl v)s v i,, ( i0 P r ,il Completion of the following table m be waived by the In ector of Wires. tit No.of Recessed Luminaires No.of Ceil:Sns No.off Total 0/ p.(Paddle)Fans Transformers KVA 'Z' No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ 'No.of Emergency Lighting grad. grnd. Battery Units o No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS lNo.of Zones No.of Switches No.of Gas Burners No.ot'betection and i No.of Ranges Total Initiating Devices g No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons KW No.of elf-Contained Totals: ......_...._...._ . r Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal Local❑ Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No. No.of Devices or Equivalent No.of WaterNo.of of Heaters KWData Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: 3 Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value El trical Work: (When required by municipal policy.) Work to Start:3/30/a j 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 ❑ (Specify:) I cerdfy,under the pairs and penalties of perjery,that the information on this application is true and complete. � ►\FIRM NAME: l \i c, O ICS ?-e k C- LIC.NO.:o� 7 Licensee: A t t tw k40;!A4s 7.s>ir Signature 04 NO.: (If applicable,enter"exempt"in the license number line.) ^ Tel. o.: Address: (, Cc��`c'y. Ld „f ( Bus.Tel.No.:.5'U 51 f1 (05 S I *Per M.G.L.c. 147,s.57- 1,security work requires Department of Public Safety"S"License: Alt.Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does trot have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ l 0434,1-89 '1 �� 6:65 amdi^