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Home My WebLink AboutBLDE-21-004075 Official Use only 0 Commonwealth of � ''� Massachusetts Permit No. BLDE-21-004075 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:1/25/2021 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) 192 SOUTH SHORE DR UNIT 2 Owner or Tenant Horizon Engagement Owner's Address SOUTH YARMOUTH, MA 02664 Telephone No. 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 ElNew Service Undgrd 0 No.of Meters Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel Y4'i ' .: a 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 mers Transfor Total No.of Luminaire Outlets KVA No.of Hot Tubs Generators KVA No.of Luminaires 2 Swimming Pool Above ❑ n- ❑ No.of Emergency Lighting No.of Receptacle Outlets 10 Battery Units No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches 3 No.of Gas Burners No.of Detection and No.of Ranges Initiating Devices No.of Air Cond. Total No.of Alerting Devices Tons ,,.../f Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: No.of Dryers Connection Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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 I certify,under the pains andpenalties o (Specify:) f perjury,that the information on this application is true and complete. FIRM NAME: Michael S Walsh Licensee: Michael S Walsh (If applicable,enter"exempt"in the license number line.) Signature Tel. NO.: 51043 Address:36 BOSUNS WAY, MARSTONS MLS MA 026481015 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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. ture �� Telephone No. PERMIT FEE:$100.00 ti G'{ (4?7/2—, Commonwealth o/Mezmachuoetts Official Use Only . r-W-` j= t ��. s Permit No. �1 - t-i-C .3 _�_ 2)epartment o ere ervieed tt i=VI Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [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: \ /m i Z t City or Town of: y OS two% khe% 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) ( qo.,. s. So r t. Dr v n't 1-' i* 2.q Owner or Tenant 14 o r 2 �` ( e n �n ti Q.Mt" i' Telephone No. Owner's Address S p„iwi,, Is this permit in conjunction with a buildin permit? Yes Le--No I ,'r`.'71 ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. • Existing Service teo Amps MCP /'ZO'j Volts Overhead --7,- Undgrd�.aA g ❑ No.of Meters _i_ New Service Amps / Volts Overhead 0 Undgrd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: RAJ..L` t414. �CittM t Mu.M_ �ti r, Q k.....vt o: .�t 1 ova S _ � t, (C,lc4r, . a i4 / t,re.1- 6iv Z 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 'Q No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches 3 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number i Tons I KW No.of Self-Contained Totals: i Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 1 kt k s T. t.b by r. Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 0Qp (When required by municipal policy.) Work to Start: j i lb/ ti 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 [ BOND ❑ OTHER ❑ (Specify:) I certify,under the pain penalties operjury,that the information on this application is true and complete. FIRM NAME: �/f t �„ Licensee: LIC.NO.: `0 y L+ Signatures(If applicable,enter "exempt"in the license nu er line.) LIC.NO.: J 1 (� 3 e. Address: Bus. Tel.No.: •L Pali *Per M.G.L.c. 147,s.57- 1 security work requires Department of Public SafetyAlt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally /Z "S"License: Lic.No. Owner/Agent req ner/ g law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner Ownred by g .e Signature ❑owner's a:ent. Telephone No. PERMIT FEE: $