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Home My WebLink AboutBLDE-21-004041 Commonwealth of Official Use Only kin- Massachusetts Permit No. BLDE-21-004041 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:1/22/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 192 SOUTH SHORE DR UNIT 1 Owner or Tenant Horizon Engagement Telephone No. Owner's Address 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: Remodel ROOM#¶4 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 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 1 .....00f Waste Disposers THeat otal Pump Number Tons , KW No.of Self-Contained Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑ Other: 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.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: Y g 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 (If 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 1 ,t)(_e i( 11Z7/z4 Town of Yarmouth Receipt No.: 62553 1/1.-1M1 1146 Route 28 Receipt Date: 01/22/2021 South Yarmouth, MA 02664 508.398.2231 RECEIPT RECORD&PAYER INFORMATION Record ID: BLDE-21-004042 Record Type: Commercial Electrical Property Address: 192 SOUTH SHORE DR 16,SOUTH YARMOUTH,MA 02664 Description of Work: Remodel ROOM#16 Payer: Applicant: Michael S Walsh Michael S Walsh 36 BOSUNS WAY MARSTONS MLS,MA 026481015 PAYMENT DETAIL Date Payment Method Reference Cashier Comments Amount 01/22/2021 Check 169 KELLIOTT $100.00 FEE DETAIL Fee Description Invoice# Quantity Fee Amount Current Paid Electrical Permit Fee 66052 100.00 $100.00 $100.00 $100.00 $100.00 AA_Receipt_Template.rpt Print Date:01/22/2021 Page 1 Commonwealth, � DD // Official Use Orly — C,ommontaealth.o/ ab�achu�etts /^ , — �� t =* _At Permit No. ,/c�IC ci ( _�-5 Thepariment o/Jire Serviced — i Occupancy and Fee Checked , BOARD OF FIRE PREVENTIONREGULATIONS 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),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: \ /(o I Z t City or Town of: Y QC moo kiln 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) ( ca. S, S 'w r t. Or \)n-%%_ 1* 1 Li Owner or Tenant ft o r `Z,p r, S.nbett,a► }t" ' Telephone No. Owner's Address S p".i, Is this permit in conjunction with a building permit? Yes No n (Check Appropriate Box) Purpose of Building E{o r4 / Mo Utility Authorization No. Existing Service .)D Amps Ito /'Z O )Volts Overhead Undgrd❑ No.of Meters t New Service Amps / Volts Overhead❑ Undgrd ri No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: c,et...•LAx ba0.4., .-04, 1 J , 2 1t c.... re Q‘.. .AAo_J��.t S _ L. (C.is .• e.1>-j 1.rel- 64 Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires 2_ Swimming Pool grnd. ❑ grnd. ❑ Battery Units �/ No.of Receptacle Outlets I No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 3 No.of Gas Burners No.of Detection andInitiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers HeatPump Number Tons KW jNo.of Self-Contained Totals: Detection/Alerting Devices Municipal Other No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Heating Appliances KW Security Systems:* No.of Dryers No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: t cS kt T. t b 1, v 1r, Q Attach additionll detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: I WO�' (When required by municipal policy.) Work to Start: I I lb/ L i 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 Vt BOND ❑ OTHER ❑ (Specify:) I certify,under the pains�� and penalties of perjury,that the information on this application is true and complete. FIRM NAME: NA, c A S L)e.t.d.t of LIC.NO.: 51 C y'S E Licensee: ,M► Utiti t Signature ,1f 4 „„,,,/ ) te,`-`d.L' LIC.NO.: 51045 (If applicable,ent er "exem t"in the license nu er line.) (11Bus.Tel.No.: '633 J0Ig Address: P. D Dolt. 13 to M r.t r^4' (yZG 41 i « „ Alt.Tel.No.: a 6 33 01 it .../ *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. I Owner/Agent Telephone No. I PERMIT FEE: $ Signature