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HomeMy WebLinkAboutBLDE-23-000418 . Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-000418 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:7/26/2022 City or Town of: YARMOUTH To the Inspector Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below Location(Street&Number) 33&37 SEASIDE VILLAGE RD c� �(1)6, P Owner or Tenant H Te ephone No. Owner's Address PO BO38, 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install basement lights. 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. IR -n 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 No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting 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 Eauivalent 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: EDWARD M LYNCH Licensee: Edward M Lynch Signature LIC.NO.: 35609 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 WIDGEON LN,WEST YARMOUTH MA 026733818 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: $80.00 R. E C E L V ..D * r� dy nems*- < J U L 2 6 202 C 4//laiseaclaaaerle Official use only : it -1GING DEPARFM,- T PerrnitNo. . o fh I JiM��lY/ICfd -- - - Occupancy and Fee Checked ' , BOARD OF FIRE PREVENTION REGULATIONS [Rev.I/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRI ' L WORK All work to be performed in accordance with the Massachusetts Electrical Code( is 527 "• t �, (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: f / City or Town of: YARMOUTH To the Ins - for of 'res: eiBy this application the undersigned .fhis her intenti.., to . el tri 1, ork ribed below. v Location(Street&Number) j-- 11 'y i j.�! J i i ' ' ©� / a Owner or Tenant i e. " '�Lsd•i:,, /., AMIN, Telephone No. / - -.7tc f.[y _ Owner's Address 7 D/P f� ` f, ee, Is this permit in conjunction with b i ..1 Yes 0 No 131 (Check Appropriate Box) Purpose of Building fid' P Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters "-5 Number of Feeders and Ampadty ,q _1 Location rNriereOPmpI Work: TJ/ 45-*ill 7&AD g 0 r !�5,p/Jy1,ft. 1;1(/ 1115- Completion of the followin Mable may be waived by the Inspector of Wires. L No.of Recessed Luminaires No.of CelL-Snap.(Paddle)Fans No.of Total Ze. Transformers KVA _ a No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires • g Pool Above In- No.or Emergency Lighting Swimming grad. ❑ grad. ❑ 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 t LI No.of Ranges No.ol Mr Cond. Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: `"'. Detection/AfertingDevices No.of Dishwashers Space/Area Heating KW Local❑ Mao 0 Otber ' Connedion No.of Dryers Heating Appliances KW So. frity S :or Equivalent No.of Water No.of No.of Data gns Ballasts No.oWiring: Neaten KW SiDevice!oruivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommnnicatioas W�r�g; No.of Devices or Equivalent OTHER: Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start Inspections 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 jEl BOND 0 OTHER 0 (Specify:) I ceHilj),under the pains and penalties ofperlary,that the information on this application is true and complete. FIRM NAME: , LIC.NO.: Licensee: �/ , ,f# _ LIC.NO.:If 5 �i Alit � Signature (If applicable, -- t t the T . line.) Bus.TeL No.• Address: CW/01 /1 i e. b .. Ql�® 7 Alt.Tel.No.• '' "�3ig Per M.G.L.c. 147,s.57-61,security work requires I . .t of Public ety"S License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that th 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. PERMIT FEE:a