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HomeMy WebLinkAboutBLDE-22-004029 �. Commonwealth of Official
29 Use Only
BLDE-22-0040
E Massachusetts Permit No.
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:1/21/2022
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) 9 HATCH RD
Owner or Tenant Kathleen Doyle Telephone No.
Owner's Address DOYLE KATHLEEN,9 HATCH RD, 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: Relocate dryer to garage.
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
Initiatine 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/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 Eauivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Signs 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 perjuty,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. PERMIT FEE: $50.00
R E w ,iI �
BAN 2 0 2022 �j
�o nwoatth of//lamas useito Official Use Only
' , �,N G D t'A R'r 1h E c� Permit No. L- `-t Q z9
4 " ��_ ---- — ni o�-sire�irvicsd
- i -I BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
. "� Rev. 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 7 CMR .00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I
City or Town of: YARMOUTH To the Inspec r of W L
:
i By this application the undersigned gives notice of his or her intention to perform the electrical work escribed below.
Location(Street&Number) ! / ,-7 e4 /Lel •
Rj) Owner or Tenant I
�c►y/C Telephone No.yi 3 t-f6(1 3113 y
Owner's Address s'A.4.
1-4
Is this permit in conjunction th a building permit? Yes 0 No El- (Check Appropriate Box)
Purpose of Building ! fi/,/,,, Utility Authorization No.
Existing Service f/ld Amps / Volts Overhead❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
tj Number of Feeders and Ampadty
•
Location and Nature of Proposed Electrical Work: t d telt, t je ,},,,„ © f Al
All Z341 uv i-.e>r t I") ii.- d r .
r, . >+�-3 r- b t r
Completion of the followingtable may be waived by the Inspector of Wires.
Ul No.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fans
. No.of
Transformers KVq
7.1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires pool swimmingAbove In- 'No.of Emergency Lighting
gr .
❑ grud. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
T Nv. o.of Switches No.of Gas Burners -No.ofDetectlon and
Initiating Devices
114 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/Alertint�Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal
Cyyonnection ❑
No.of Dryers Heating Appliances KWS No of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
HSigns Ballasts No.of Devices or Equivalent _
No.Hydromassage Bathtubs No.of Motors Total HP 'fel No.of Deviic test or Wiring:
OTHER:
�, Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of lectrica �
l Work: VI
(When required by municipal policy.)
to Start: / 'Z 7h Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE VE E: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee p vides 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 1121` BOND 0 OTHER 0 (Specify:)
I certify,under the ns and penalties of perjury,that the rmation on this application is true and complete.
FIRM NAME: A.. ..Gl e,-0-,,,..... l /idu 1 isr- LIC.N #�
Licensee: P . a/ t Signature ,,.4( „- LIC.N i� 6 C�t
(if applicable,enter"ems/mpid th license number line.) Bus.TeL No.:
Address: p bor. 1/Z/ e/4-.inv✓/4,. / Alt.Tel.No.:
*Per M.G. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER 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