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Home My WebLink AboutBLDE-21-004076 Commonwealth of Official Use Only 11.141. Massachusetts Permit No. BLDE-21-004076 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 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 0 Undgrd 0 New Service gNo.of Meters Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Rem k. r `!0 l' `; i 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- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 10 No.of Oil Burners FIRE ALARMS 1No.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 \%„„,,46f 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 ❑ Municipal Connection 0 Other: No.of Dryers 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 Devics 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 (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(If applicable,enter"exempt"in the license number line.) Tel. N.: 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 Owner/Agent ) 0 owner 0 owner's agent. ,c .....,ture Telephone No. / PERMIT FEE:$100.00 gred( 1/737/2( e Commonwealth o//r/amachudetts Official Use Only -it. sue- c� Permit No. =�1_ Thepartment ol5ire Serviced Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] \v� (leave blank) .. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: , t l$ I Z t City or Town of: co-Nw u vv. 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) I Rt. S. S`No r c Or V r,"‘1- i 3 6 Owner or Tenant 14 d r Ito n E.n gyts1.‘mt." Telephone No. Owner's Address S pw..c., Is this permit in conjunction with a building permit? Yes 1 �r".'71 No El (Check Appropriate Box) Purpose of Building Aft Utility Authorization No. Existing Service Amps YEA /7004b Volts Overhead Undgrd❑ No.of Meters New Service Amps / Volts Overhead I I Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Rem..LA SS 3. . 00 M 1 t �•••Z ('e Q L../A a,,,)1-.a,S _ UYC (C.lt1..... a ig 1.M.4. 64 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 0 No.of Oil Burners FIRE ALARMS INo.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 I Number I.Tons I KW No.of Self-Contained Totals: [ Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal Local❑ Connection ❑ Other No.of Dryers Heating Appliances KWSecurity Systems:* No.of Devices or Equivalent No.of Water No.of Heaters KW 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: I ^'►ukt A .S.r 'T:bn b f •1) Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: /000-- (When required by municipal policy.) Work to Start: I I$I 2,1 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 [a'' BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: 1V1.tc { S L)as1.% vr- Licensee: ` S LIC.NO.: Q y (If �ti �+ Signature T_ LIC.NO.: J v 3 , line) applicable,enter exempt"an the license nu er li Address: Bus.Tel.No.: •4, rpig *Per M.G.L. c 147 s 5 7 61,security work requires Department of Public Safe Alt.Tel.No.: Ig 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 a.ent. Owner/Agent Signature Telephone No. PERMIT FEE: $