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Home My WebLink AboutBLDE-22-005568 Commonwealth of official Use Only Massachusetts Permit No. BLDE-22-005568 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:4/1/2022 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) 32 SHORE RD Owner or Tenant PAYNTAR JOHN W Telephone No. Owner's Address 32 SHORE RD,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 Box) Purpose of Building Utility Authorization Existing Service 100 Amps Volts Overhead 0 Undgrd 0 New Service 200 Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service 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. 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 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 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: PAYZANT ELECTRICAL CONTRACTORS Licensee: Kevin Mott Signature LIC.NO.: 22677 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 118 Long Pond, South Yarmouth MA 02664 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 A6�y2 rE .....-- 14 Commonwealth o`Maeeachueelfa OfficialyUse Orsi ,• ' •r c� c7 Permit No. X22 �L.Jepar6aresi o/.}ine&mic s - 6.:1."1' • Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), MR 12.00 Si (PLEASE PRINT IN INK OR TYPE ALL INFORM1 r)ON Date: �1 City or Town of: g ,i(1/(Y.10 (1c(Yl Q Vl To the Inspector o fres: By this application the undersigned es notice of his or her initerion to orm the electrical work described below. Location(Street&Number) 3 a 5 o i-Q_ a_ Owner or Tenant w •. •It_ elephone No. Owner's Address __ *1' IF 411111111INIP i r rn/ VNJ. A • / - Is this permit in conjunction with a building permit? Yes 0 No (Check Appropriate Box) 44 Purpose of Building b(jJQ l Utility Authorization No. Stp O(LS ExistingServiceAmps /` olts Overhead® Undgrd 0 No.of Meters le... IoQ New Service P.Q O Amps / Volts Overhead❑ Undgrd 0 No.of Meters 1 �' Number of Feeders and Ampadty L,�J Location and Nature of Proposed Electrical Work: II ,' r EC tight si "..€ w�i Completion of thefollowingtable may be waived by the Inspector of Wires. otal No.of Recessed Luminaires No.of Ceil.� (Paddle)Fans No.a oof TVA usp• Transformers KVA Q. KVA G1 No.of Luminaire Outlets No.of Hot Tubs Generators n Above In- No.of Emergency Lighting *. No.of Luminaires Swimming Pool fund. 0 fund. ❑ Battery Units `-/ No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones \-- No.of Switches No.of Gas Burners TIo.of Detection and c. Initiating Devices tal I'z' No.of Ranges No.of Air Cond. To No.of Alerting Devices No.of Waste Disposers Heatns Pump Number Tons KW No.of Self-Contained Totals: .. Detection/Aler Devlces No.of Dishwashers Space/Area Heating KW lAxal 0 Cnnectton 0 0*herNo.of Dryers Heating Appliances KW N*Security y!Devices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Tel No.of Wiring: Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lectri I Wo O O . (When required by municipal policy.) Work to Start: 3 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERA E: 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 certify,under a , and nes,, o rJu ,that thea ,, ,n on is , -lication is true and complete. FIRM NAME: _o Am . 1 a w . :g bat LIC.NO.:, AIP Licensee: 1 i MIUMI Signature it ,. g LIC.N i. r (If applicable,ent em in the lice+ !umbar i Bus.Tel.No. !'�Fri `13 Col Address: l..Q 'r(1 CIO d. Q I mO Mf Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,s�work requires De�arttnen�Public Saf "S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability i4surance coverage normally required by law. B y signature below,I hereby waive this requirement. I am the(check one) owner 0 owner's agent. Owner/ V` a-- PERMIT FEE:$ Signature - �—_ Telephone No.S66 D aoyI