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Home My WebLink AboutBLDE-21-004044 Commonwealth of Official Use Only illkA) Massachusetts Permit No. BLDE-21-004044 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: Remodel# I 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 2 Swimming Pool Above ❑ In- CINo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 10 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 3 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices • Tons ��f Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting 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 ofperjury,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 5ture Telephone No. PERMIT FEE: $100.00 `t,04..u( 2 kct(2A lIfE— Commonwealth.o/IVamackoettd Official Use Oily A 4 = _ I c� Permit No. lj_' )4 v�i= . Z epartment o/ ire Serviced __ 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: \ 't b 1 Z t City or Town of: y a,C Nwv VL. 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) I qt. S. S np r t. Or \.)n %i' i* 18 Owner or Tenant 140 r 120 '.nvte,ow% A- Telephone No. p•� Owner's Address S e.. Is this permit in conjunction with a buildin permit? Yes L No ❑ (Check Appropriate Box) Purpose of Building 4ko / Mo r 4 Utility Authorization No. • Existing Service az Amps Vt /7004b Volts Overhead 12"-- Undgrd No.of Meters New Service Amps / Volts Overhead Undgrd n No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 944%,.,.LIA toik �00th 1 t t.,..a. r e Q�,.....41 o�J IJ J S _ us:rt. (c.10,... e 14-/ 6� Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:SusP•(Paddle Fans Tf Total) Tr Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Z.. Swimming Pool grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets `0 No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches 3 No.of Gas Burners Initiating Devices Totallo.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers HeatPump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other Heating Appliances KW Security Systems:* No.of Dryers No.of Devices or Equivalent No.of Water Kam, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: 1 IA1)kt A t•GA.• i T. R. V ‘0y F . 1) Attach addittional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 1000.i (When required by municipal policy.) Work to Start: I I b' t% Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COtERAGE: 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:) I certify,under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Kt tc/L4f1 S d)C t yr LIC.NO.: 510`I S E Licensee: }A c..Lit s �titiLt Signature - .._„0 ) t. LIC.NO.: 51043 E. (Ifapplicable,enter 'exempt"in the license nu,Aber line.) fiBus.Tel.No.: 'C33 50161 Address: d l3 62c !l ¶ Alt.Tel.No.: as 6 33 OS'( P. *Per M.G.L.c. 147,s.57-61,security work requires� '""'"Y vDepartment 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)❑ owner ❑owner's agent. Owner/Agent Telephone No. I PERMIT FEE: $ Signature