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Home My WebLink AboutBLDE-21-006047 Ai)P Commonwealth of Official Use Only Ems, Massachusetts Permit No. BLDE-21-006047 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:4/21/2021 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 electncal work described below. Location(Street&Number) 184 SOUTH SEA AVE`' ifI 17 Owner or Tenant Sandy Shores, LLC. Telephone No. Owner's Address 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 ❑ 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: Wire bathroom, kitchen, bedroom, &livingroom. 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 0 In- ❑ No.of Emergency Lighting grnd. grnd. 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 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 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens Ballasts 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 perjury,that the information on this application is true and complete. FIRM NAME: DANIEL J PECKHAM Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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 Signature Telephone No. PERMIT FEE:$100.00 GtraWLi12.6 (2,1 (RAA w7 pii c 0lN-ir SpAcE, ►4gfJao Pill 4' 2/17 rte' s aiVsp Oic e 3/1(1-72,- . SCC _� c( Commonwealth o`Maastsclumeas Official Use inly '� 2separ6nsnt 4 Sewer Permit No. ( 2t. -7 • -�` 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(M C).527 CMR 12.00 Li (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1 vilCity or Town of: y n t,Q� To the I tor f Wi�: By this application the undersign6d gives notice of his or her intention to perform the electricalwork described below. Location(Street&Number)t q ,50ii7-�„s„G� . Ave _ IJ K t I /7 Owner or Tenant Sec t,.0-0t. 'tom&C Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No El (Check Appropriate Box) V) Purpose of Building dilly Authorization No. PExisting Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: iv.;iv.., A . it ,aii,k erj„s r d,,,7 Completion of the followingtable may be waived by the lavector of Wires. Total No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators EVA No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grad. gent Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 14o.of Detection and Iniitiating Devices o No.of Ranges No.of Air Cond. Toon l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW_ No.of Self-Contained Totals: --`__ _ Detection/AleDevices No.of Dishwashers Space/Area Heating KW Local❑ Mu 0 Other Cyonnectlont No.of Dryers Heating Appliances KWteculitfDevices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent iring No.Hydromassage Bathtubs No.of Motors Total HP Telecomm Device ons Equivalent No.of Devices or Equivalent _ OTHER: Attach additional detail if desirect 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: INSURANCEBOND 0 OTHER 0 (Specify:) I certify,under the pains and perm of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee a..,,j. J '�. Pate kkav+z Signature 01,4,4).„&AJL2 LIC.NO.:a L, O (Ifapplicable.enter"ext"in the license number line.) Bus.Tel.No.. Address: r1 akk Je 5 2..A. mG r1,Si 8.�n, ,/14 d_G S Alt.Tel.No.:Se -'Y2G 31i— *Per M.G.L.c. 147,s.57 1,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)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$