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Home My WebLink AboutBLDE-22-000810 Commonwealth of Official Use Only f1` %- Massachusetts Permit No. BLDE-22-000810 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:8/12/2021 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) 669 ROUTE 28 Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address PARK DEPT, 1146 ROUTE 28,SOUTH YARMOUTH, MA 02664-4463 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: Temporary power for event. 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. rnd. 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. Tonal 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 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eouivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eouivalent 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: PETER VERMYNCK Licensee: PETER VERMYNCK Signature LIC.NO.: 22490 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:5 CAPTAIN KIDD RD, EAST SANDWICH MA 02537 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: $150.00 1 Coaawwoauiea j o`cc177//ashed's/4.M Official Use Only es -Apartment of Jir.Jswic a Permit No. 22 j i; z' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1107] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC).57 12.00 6 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: i 2 ( 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. Locadon(Street&Number) C 6 Ct q J tE Z t Owner or Tenant ?'bwA. tDP ViA R0404414 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No Q (Check Appropriate Box) Purpose of Building --- Utility Authorization No. Existing Service Amps I Volts Overhead❑ Undgrd❑ No.of Meters NOW Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: -1-cotpeg 4 RiffFkswta. Po R. evErkir -'"t Completion of the foilowinkiable may be waived by the inspector of Wires. No.of Recessed Luminaires No.of Cel.-Snap.(Paddle)Fans Trani Total �` Transformers KVA .=.t No.of Luminaire Outlets No.of Hot Tubs Generators KVA e No.of Luminaires SwimmingPool Above ❑ In- ri No,of Emergency Legating - 4. _and. I--1 Battery Units No.of Receptacle Outlets ,.of Oil Burners FIRE ALARMS No.of Zones No.of Switches Na.of+{ races "No.of Detection and Initiating Devices No.of Ranges No.of Air Coad. Ton 1 No.of Alerting Devices No.of Waste Heat Pump Number Tons W No.of Self-Contained Disposers Totals: .""-`"_ "`"""_."" �Deteetioa! Devices No.of Dishwashers Space/Area Heating KW „ ❑ nnl pal Q Connection No.of Dryers Heating Appliances KW' leeVo.0 ., : . or Equivalent No.of WaterKVirHsNo.of No.of Data Wiring::stets Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total NP �Telecommtatt dons W i�' No.of Devices or Eq at OTHER: Attach additional detail if desired,or as requhvd by the Inspector of Wires, Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: "—""`•`" 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 $ BOND 0 OTHER 0 (Specify:) I cer Wjy,under the pains and ofpelf cry,that the Information on this application is true and complete. FIRM NAME: q1;R b Ft'LEC; t G LIC.NO.: A 22$4"tb Licensee: GK Signature Q LIC.NO.: (If applicable.enter"e pt"in the licensen e.line Bas.Tel No.:, Address: •>. b* 1 ST 6 4 Nsbw t+�t� 10} Ca c 3, 7 S e1' � Alt.Tel.No. *Per M.G.L,c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)D owner Q owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ ,