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Home My WebLink AboutBLDE-21-004039 Official Use Only Commonwealth of a ,, ',44\ Massachusetts Permit No. BLDE-21-004039 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:1/22/2021 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 1 Owner or Tenant Horizon Engagement Telephone No. Owner's Address 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 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remo' , ' ' ---"ff` Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires 2 Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 10 No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches 3 No.of Gas Burners Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained �of Waste Disposers Totals: Detection/Alerting Devices Heating Local 0 Municipal No.of Dishwashers Space/Area KWConnection ❑ Other: HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Siens Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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: Michael S Walsh Licensee: Michael S Walsh Signature LIC.NO.: 51043 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:36 BOSUNS WAY, MARSTONS MLS MA 026481015 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 ture Telephone No. PERMIT FEE: $100.00 p,,,,„tic i (i (2-1 Ng-- qq-(7k -� -e- Le,(lrl (uc aa/ ��/� Official Use Onl Commonwealth o/�a�eacivaetti Official — ¢. !Y� i _*=-_ / cc�� Permit No. 0(' �( 9 -�1-i Thepartment of Jiro�ervice3 Occupancy and Fee Checked «_ -- BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) L' 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 b I Z t City or Town of: y ac Moo N'U. To the Inspector of Wires: By this application the undersigned gives notice of�ao his or her intention to perform the electrical work described below. Location(Street&Number) I S m. S. << Pr V 1 r %4' i , Owner or Tenant ft d r Ito E.n t.4c�t,Mt,', k" Telephone No. Owner's Address S pw�t, J Is this permit in conjunction with a buildin permit? Yes No ❑ (Check Appropriate Box) Purpose of Building A otrc4 , t o Utility Authorization No. • Existing Service 1506 Amps Yl a /ZO b Volts Overhead j Undgrd❑ No.of Meters L New Service Amps / Volts Overhead n Undgrd n No.of Meters Number of Feeders and Ampacity , Location and Nature of Proposed Electrical Work: 9, `1,...• bblL. %--0o M t.." . Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires 2. Swimming Pool grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets I 0 No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches 3 No.of Gas Burners Initiating Devices Total No.of AlertingDevices No.of Ranges No.of Air Cond. Tons No.of Waste Disposers Heat Pump I Number'Tons 1KW No.of Self-Contained Totals: Detection/Alerting Devices Other No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ HeatingAppliancesSecurity Systems:* No.of Dryers KW No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters Signs KW Ballasts No.of Devices or Equivalent Telecommunications Wiring No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: I ^au k t C4 I-c,4. :7 1, 1) `O/ c I . Attach a itional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 100U'' (When required by municipal policy.) Work to Start: 1 V I lb/ Z.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 ( BOND ❑ OTHER ❑ (Specify:) nd I certify,under the�w� aNO.: 5ipains�� and penalties of perjury,that the information on this application is true LIC.complete. plet . O y� FIRM NAME: ► S Q �� v- Bus.Tel.No.:Licensee: � �� LIC.NO.: J 1 v y 3 E. �„�,,,kl.t Signature .G33 SOli (If applicable,enter "exempt"in the license nut er line.) �`ZG U Alt.Tel.No.: 633' 14 Address: P. 013 AA V 1 1 *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 herebye that he Licensee does not have the liability requirement. I am the(check one)tnsurance❑ownerco�age owner normally agent. required by law. By my signature below, Y pERMIT Owner/Agent Telephone No. Signature