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Home My WebLink AboutBLDE-22-003814 Commonwealth of Official Use Only "I.. ,t " Massachusetts Permit No. BLDE-22-003814 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:1/7/2022 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) 904 ROUTE 6A Owner or Tenant Kristine Goodwin Telephone No. Owner's Address 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: Replacement boiler. 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 1 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 ❑ 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 Ballasts Data Wiring: Heaters Siens 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 Nrbk. ill n(2.-z (11).tcg ) RECEIVED JAN v 7 2022 muse h of Illemeaclumslie Official Use Only „,,o1 NG DEPARTME T c71PenrdtNo, l fa 3 Q (Lt ,),1 1' `. r'.,r.� Z' 7S7 l o ervicee '. Asir1 ----rf 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 TYPE ALL INFORMATION) Date: / —7 — 1;1— City ,ZCity or Town of: YARMOUTH To the Inspector of Wires: By this application the undersignives notice of his or her intention to perform the electri work described below. ed OW— Location(Street&Number) (} V 6i,-r.,..4e;•-k- (/?iT- L,, L. ✓ c- 6.41 Owner or Tenant 6 t 71.1 wt a 4 11.�.,,—1 ( Telephone No. Owner's Address Is this permit In conjunction with a building permit? Yes 0 No .. (Check Appropriate Box) Purpose of Building J, LC.-•Lc Utility Authorization No. Existing Service/t i Amps /Lt// a Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty t, i_i_, g d y,,Z._ /3‘ /c— _IL,/7., v 6/r Location and Nature of Proposed Electrical Work: / j vt Completion ofthefollowingtable m-be waived by the I cto�of Wires. l�l/i No.of Recessed Luminaires No.of CdL-Susp.(Paddle)Fans No.ofjal (2. Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA k No.of Luminaires Pool swimmingAbove In- No.of Emergency Liviang ttrnd. trnd. ❑ Battery Units _ No.of Receptacle Outlets No.of OH Burners FIRE ALARMS [No.of Zones No.of Switches No.of Gas Burners -No.of Detection and Initiating Devices 11,1 No.of Ranges No.of Air Cond. Tota No.of Alerting Devices 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 Connection 0 Omer No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of 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: Q� i ei Attach additional detail if desired.or as required by the Inspector of Wires. Estimated Value of Electrical Work: L� (When required by municipal policy.) Work to Start: '7 Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE 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 cov7age 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 pal d pen es ofperjury,that the info orlon on this appl& don is true and complete. FIRM NAME: , / L- w7 ,ft"t/) �� LIC.NO.: Licensee: /.h/f /29 Signature ..,.. Z 4 LIC.NO.. L.& (Ifapplicabie,;ter"exempt"in thd'license number line.) Address: „ ._ //Z / _,. Bus.Tel.No.: t Alt.TeL No.:�vi c. ) 6 (6 3/ *Per M.G.L 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 ❑owner's agent. Owner/Agent I Signature Telephone No. I PERMIT FEE:$ 1