HomeMy WebLinkAboutBLDE-21-004120 ..o• Commonwealth of Official Use Only
Permit No. BLDE-21-004120 E.` Massachusetts ,
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
JRev.I/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:1/26/2021
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice or his or her intention to pertorm the electrical work described below.
Location(Street&Number) 192 SOUTH SHORE DR
Owner or Tenant Horizon Engagement Telephone No.
Owner's Address 192 SOUTH SHORE DR, 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: Renovate
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 2 Swimming Pool Above ❑ In- o No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets 10 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 3 No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
hof 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 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: Michael S Walsh
Licensee: Michael S Walsh Signature LIC.NO.: 51043
(/f applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:36 BOSUNS WAY, MARSTONS MLS MA 026481015 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) 0 owner 0 owner's agent.
Owner/Agent
ture Telephone No. PERMIT FEE: $100.00
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t _* -tit a Permit No. Z( Lk( ZO
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• -N__----.1 Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07
' ,-�,,c (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: \ /1 t I Z.A
City or Town of: Y QC Mo V N'Ne‘ 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) ( q1 S. S 'w f 4 Or V n'11- i 3
Owner or Tenant P d r `Zp F nwtt.Me.,x A' Telephone No.
0,40b-c.,Owner's Address S0,40b-c., J
Is this permit in conjunction with a building permit? Yes ar.°-No n (Check Appropriate Box)
Purpose of Building !•(4,4 1 Mo Utility Authorization No.
Existing Service 506 Amps YLo /7,O )Volts Overhead 1 Undgrd❑ No.of Meters (
New Service Amps / Volts Overhead n Undgrd 17 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: ..Lk a804%. �l.wM t t C.N.-Z
r.- 9‘..,.,l1 a:.101-a' _ tajNit (4 kAw" ¢,14/ %.,41. bot
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 2._ Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets 1 e No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 3 No.of Gas Burners No.of Detection and
Initiating Devices
Tot
No.of Ranges No.of Air Cond. Tons 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 11:1 Connection
Connection ❑ Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of WaterNo.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: t c�^'%u kt 1-G4.1ec T1 (3.1) ....
\-4y 1. . p
Attach additionkl detaif desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: / OO (When required by municipal policy.)
Work to Start: Il b/ 21 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE CO ERAGE: 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 E BOND ❑ OTHER ❑ (Specify:)
1 certify,under the pains and penalties of perjury, that the information on this application is true and complete.
FIRM NAME: KA,,j,t„4A S ua6L %(" LIC.NO.: 51 O 43 E
Licensee: ik:cdtoit UG..k L ( Signature —��,1. A �i, LIC.NO.: 5 C)y 3
(If applicable, enter "exempt"in the license nu er line.) V�---y' Bus.Tel.No.• -633 J01g
Address: P. d i3 to Imo^' ro (' Z( y g Alt.Tel.No.: OS 633 wig
*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)❑owner ❑owner's agent.
Owner/Agent I
Signature Telephone No. I PERMIT FEE: $