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Home My WebLink AboutBLDE-22-003194 0 Commonwealth of Official Use Only fil% Massachusetts Permit No. BLDE-22-003194 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:12/6/2021 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) 19 SEDGEWICK PATH Owner or Tenant Michael Mellor Telephone No. Owner's Address 19 SEDGEWICK PATH,WEST YARMOUTH, MA 02673 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: Install receptacle for water heater. 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 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and p Initiatine Devices No.of Ranges No.of Air Cond. ToNo.of Alerting Devices 1 ri 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: A 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 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. l PERMIT FEE:$50.00 �"l i (-74 )( i / 0 /h ,`(/N/ Nit!'c tzf$194 ((-1 / RF. CFWFD � OEC 0 3 2021 11.0 7 ,_...6 C.omunonwaa[h of i dmaduaetfe \ F lJILDINUt�A � pNOfcial Use Only .'� 7 Z' )9ii: epartment o/ 'I.tiC tl Occupancy and Fee Checked I� BOARD OF FIRE PREVENTION REGULATIONS Rev. "71 (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 c (PLEASE PRINT IN INK OR TYPE ALL INFORMATTON) Date: / Z/J / Z 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. 0 Location(Street&Number) Jf e' w / c ��71 Owner or Tenant / C 4,< c 7 /2-.1 r /lc,r Telephone_r'yo/./7}0 7 J Owner's Address ` ` y 3L y L Is this permit in conjunction with a building permit? Yes 0 Noc (Check Appropriate Box) Purpose of Building ,',,,,(„1Utility Authorization No. Existing Service7r/4_, Amps / Volts Overhead❑ Undgrd/vg 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampaclty Location and Nature of Proposed Electrical Work: O ✓ 77, 7 ,' , 7 A/- / ' t° 2,-( t.. P A-,C C // ci Lr 7 r 7--- . . Completion of the followingtable nw be waived by the In for of Wires. Lb Na of Recessed Luminlres Na of Celt-Snip.(Paddle)Fans No.of 1 t- Transformers KVA No.of Luminaire Outlets Na of Hot Tubs Generators KVA Na Of Luminaires Swimmin p� Above In- Ivo.of l�mergeacy Lighting ' g �rnd. ❑ Rind. ❑ Battery Units `t No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones Na of Switches -Na of'etection and t No.of Gas Burners Initiatins Devices t1.! Na of Ranges No.of Air Cond. Tonsi No.of Alerting Devices Na of Waste Disposers Heat Pump Number Tons KW_ No.of Self-Contained Totals: Detection/Alerting�pevices No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ ' Na of Dryers Heating Appliances KW Security Systems:* Na of Water KW No.of No.of Data W evicea or Equivalent HeatersSigns Ballasts No.of Devicesbringor Equivalent Na Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: Na of Devices or Equivalent OTHER: L a Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Worktfrd a (When requited by municipal policy.) Work to Start / Z L/ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE,C 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. CHECK ONE: INSURANCE--BOND ❑ OTHER 0 (Specify:) I certify,under the and pens of perjury,that the bs faation on this application is true and complete. FIRM NAME: � � /cc /� l ...t_ LIC.NO.. 2 Licensee: JAI) / v c A_ Signature ``,� LIC.NO.��o C flfappikabf enter"exempt" he license number line.) Address: s b / 2 i U.114,•-,, 4, / Bus.Tel.No.�'7/lcj1? 0 ��/ �� / G 2 < t—�� .Alt.Tei.No.. *Per M.G E.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER5S 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ I Z