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Home My WebLink AboutBLDE-22-000300 co Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-000300 '0...-0 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:7/19/2021 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) 25 MID-TECH DR Owner or Tenant DUPUY MATTHEW J Telephone No. Owner's Address RIGHT PATH ASSOCIATES, 25C MID TECH DR,WEST YARMOUTH, MA 02673 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 f , New Service Amps Volts Overhead 0 Undgrd 0 464, eter Number of Feeders and Ampacity40 46/ Z,L Location and Nature of Proposed Electrical Work: Wiring for basement bathroom. �} Completion of the following table may bewwaiiveJ�by s fbr/o • s. of Ceil:Sus . Paddle Fans No.of V ,1,ia(`f No.of Recessed Luminaires No. P( ) Transformers Ait No.of Luminaire Outlets No.of Hot Tubs Generators s Cif 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 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 P Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* ry 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: LANCE A MACENERNEY Licensee: Lance A Macenerney Signature LIC.NO.: 11149 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 126A MID TECH DR,W YARMOUTH MA 026732560 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 ROC) jii" 7hIl '` _ Commonwealth.o/Masdaguoito Official Use Only 7C� Permit No. e-2Z—030� �l 2)epartmeni o/.ire Serviced E! ,,, 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: 7/)Li Pi City or Town of: :`Y!r!.�.iYl1) i 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) ,9 J a)►d TeC.h 1, ( Map Parcel# 'tf 1 c L Owner or Tenant ifht,i/J iANI Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building M or,t'_X i c._,4 Utility Authorization No. Existing Service Amps / Volts Overhead❑ 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: ire i (2-e- bek- V 6 6 crN bck S Q rn ein�- (L c3 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 Tratiisformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA N®.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting brad. 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 Initiating Devices No.of Ranges No.of Air Conti. Toms No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW' No.of Self-Contained p Totals: "" "' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other Coaned1011 No.of Dryers Heating Appliances KW Security ems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring; Heaters Signs Ballasts No.of Devices.or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsfDevic Wes��•• No.of Devices or E.quivdent 01HIf R: Attach additional detait if desired,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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 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: F�1 l�e c� F. t c�-; ('I,(y, \y LIC..NO.: �1 ll1 1� Licensee: Le-V 1 i i t Y1 to\-e.y Signature ,_—.) LIC.NO.: (If applicable,enter"exempt"in the license number. line) Bus.Tel.No.: 6 T-1l 5' O0 30 Address: Alt.Tel.No.: *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 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:.$ tt.) *IR i1PORTAlelT! A sanarata narmit is rant irad far tha installation of smoky(10w:tors-Firs!Alarm insnantions ara narfnrrnad by tha Fl havinn ii irisdintinn