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Home My WebLink AboutBLDE-21-006207 Commonwealth of Official Use Only 11!%• Massachusetts Permit No. BLDE-21-006207 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:4/27/2021 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) 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 (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: Replace receptacles,switches, &light fixtures. 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 Tons _ No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertinu 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 HPTelecommunications 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: 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 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: $250.00 VGj err-- (flij NOV tleCIPI1 t2g1 PCI aS {a4t2-1)/111 1411 Z7-' 14 Commonwealth o j Maaeachmotto Official Use Only $. ' •� c� �f c7 nn Permit No. `-2 -6,7-401 2epar trent o�..tin.Serviced cs gJ.- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) (leave blank) - ' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK _ V All work to be performed in accordance with the Massachusetts Electrical Code(MEC?,527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFOR 4 TION) Date: f/./ a, I Cityor Town of: rmnu To the Inspector oWires: By this appation the undersigned ves notice alms or her intention to performn' electrical wo 'bed below. Location(Street&Number) 3 a Shoo. Rock,0 V V � Jeer Q(/� ' Owner or Tenant 0%,i"}>n,R jr Telephone/ , ini 0 I-- (9a 3 �'', Owner's Address '5O-XY)-12, I , ♦ �� Is this permit in con unction will‘a building permit? Yes 0 No NI (Check App , to - Purpose of Building , Z 01 C' Utility Authorization No. ;1, , 3 Existing Service 1 C;C Amps 1 Q / - 11 Volts Overhead Undgrd❑ o. etersR c 7 1, New Service Amps / Volts Overhead 0 Undgrd 0 II''oLh fen j Number of Feeders and Ampacity /�y R Location and Nature of Proposed E Work: 6.QADI a LQ 1 t i 0 ...S .��(,A; - t q, Wir\d \1 C§V\ 1 k / Completion of thefollowingtab/t towy be waived by the lnvector of Wires. W No.of Recessed Luminaires No.of Cell (Paddle)Fans No.of Total .' Transformers KVA!-1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA o <k No.of Luminaires SwimmingPool Above ❑ In- ❑ Bot er Units Ltgattng grnd. grad. Battery Unit .9 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and No--- Initiating Devices 11' No.of Ranges No.of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tops KW........ No.of Self-Contained Totals: .___ _.___.____.._. Detection/AlerpsAllevices No.of Dishwashers Space/Area Heating KW Local 0 reo=lOn 0 Other No.of Dryers Heating Appliances KW Security rs of Devices*or Equivalent No.of Water , No.of No.of Data Wiring: _ Heaters KSigns Ballasts No.of Devices or unicadonsSot No.Hydromassage Bathtubs No.of Motors Total HP Telp o f Devicesor Slept OTHER: , Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of El 'cal Work: 16 0 0• ü V (When required by municipal policy.) Work to Start: 1- \ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 , , and pe ,, ofiterjuly,that „n on , m:is late acrd co FIRM NAME: _ ; . LI r( (' i IR, C. l L LIC.NO.: ��Q( 7—1 Licensee: $A , I NA Signature -- LIC.NO.: f (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.. 'I L3 Address: Alt.Tel.No, "fAMMIrai ` Sc GCcI \ 'Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By y signature below,I hereby waive this requirement. I am the(check one ■ owner ■ owner's :ent. Owner/ n Signature Telephone No ci C-F 9 —7 PERMIT FEE:$ leP