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Home My WebLink AboutBLDE-22-004320 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-004320 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:2/3/2022 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) 340 HIGGINS CROWELL RD Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463 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: Wiring for HVAC controls&thermostats. 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 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 Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent 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 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: Ryan T Mann Licensee: Ryan T Mann Signature LIC.NO.: 21817 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 114 STANDISH ST, PEMBROKE MA 023593335 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: $0.00 At �� - irJ' I I e ``, 1 G,..- f- Ti1,5,...)1 ot A c Commoruuea th of 2 assac/.usalts Official Use Only • R E C E ' _�1=-i 2epartmanf o{.fire Jcrtricel Permit No. ' _ _ ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 'Rev. 1/07] f FEB 03 2 (leave blank) r dD_, 1 itATte1k1 r-e,r. r,..-.-....- - - - . .-�.. . •i•ii t v rcr�rvr[m tLtl; I t{IGAL WORK BUILDING DEPARTMEN All work to be performed in accordance with the Massachusetts EIectrical Code(MEC),527 CMR 12.00 • 'SE PRINT IN INK OR TYPE ALL I2VFORIvL4TI0 N) Date: a YARMOUTH 3 Cityor Town of: To the Inspector of Wires: By this application the jlndersigned gives notice of his or her intention to perform the electrical work described b w.. o,, Location (Street&Number) 3`1 L1 1-1 ;n f CIc -Jell R'd POI j�_ � .. Owner or Tenant Yc\r roc „tk c.� `0 t F 2; t"`�^t Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building (on,.. r;t;w' Utility Authorization No. Existing Service Amps / Volts Overhead E Undgrd❑ No. of Meters New Service Amps / Volts Overhead E Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: N.v7 L C 1!t Coivt-ro 15 - c,r .. ( - r-. Is . Completion of the folawinz 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 IJmergency Lighting :?rid. Qrnd. Battery Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatrna Devices Total No.of Ranges No. of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump Number TonsKW _ No.of Self-Contained Totals: I H- Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local E Municipal ❑ Other t Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water KW No.of Devices or Equivalent No.of No. of Heaters 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: 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: "3 -c� 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 cov rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the p ins and penalties of pertjjury that the information on this application is true and complete. FIRM NA E: a1r14�✓t C It Eft c,s.\ LIC.NO.: a I - /4 Licensee:T•1'1r P/Vt101 Signature At. LIC.NO.: (If applicable',enter "es t"' the license number ine. I Bus.Tel.No.: . Address. II`I j fAAo t ik j rt.-+.�proIN_ II-6 Alt.TeL No.: 7t l 3 - 4 F P e j *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 S required by law. By my signature below, I hereby waive this requirement I am the(check one)❑owner ❑owner's agent 7 Owner/Agent I Signature Telephone No. I PERMIT FEE. $ (� Cc!('-'it Cy