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Home My WebLink AboutBLDE-21-004069 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-004069 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:1/25/2021 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 electrical work described below. Location(Street&Number) 192 SOUTH SHORE DR UNIT 2 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. - x 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- ❑ No.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 .....,.if 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 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: 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 Iture Telephone No. PERMIT FEE: $100.00 re(t1 (, Town of Yarmouth Receipt No.: 62601 t„ 1146 Route 28 ` South Yarmouth, MA 02664 Receipt Date: 01/25/2021 508.398.2231 RECEIPT RECORD&PAYER INFORMATION Record ID: BLDE-21-004070 Record Type: Commercial Electrical Property Address: 192 SOUTH SHORE DR 24,SOUTH YARMOUTH, MA 02664 Description of Work: Remodel ROOM#24 Payer: Applicant: Michael S Walsh Michael S Walsh 36 BOSUNS WAY MARSTONS MLS,MA 026481015 PAYMENT DETAIL Date Payment Method Reference Cashier Comments Amount 01/25/2021 Check 169 KELLIOTT $100.00 FEE DETAIL Fee Description Invoice# Quantity Fee Amount Current Paid Electrical Permit Fee 66099 100.00 $100.00 $100.00 $100.00 $100.00 AA_Receipt_Template.rpt Print Date:01/25/2021 Page 1 Commonwealth o/Mamachu4et �fficial Use Only ► a , c� Permit No."" — `ou 1 , " _`0t T epartment o/.Jire Servicee 1. _ Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. ,,41/07] (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: \ '{b I Lt City or Town of: y co. ..).vv, 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 \o r t. Or v rn %k- tt L 3 Owner or Tenant ft d r Ito r, S.ett,yQ.MV',, A Telephone No. Owner's Address S 0. .4.. Is this permit in conjunction with a buildin permit? Yes No ❑ (Check Appropriate Box) Purpose of Building 4{o1r4 , Aft r 4 Utility Authorization No. • Existing Service Amps 1 L /2.01b Volts Overhead I Undgrd❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature OVA Proposed ,� ,ai -L ��M Electrical Work: 9 .•LA 1 .e t_' . rt co 4...� o:.� r 4 S _ t,i cc. 1C,,4(44. ¢.1,14 t. tl- 64C Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf T Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires �. Swimming Pool grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets 'tp No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches In No.of Gas Burners No. Dete and nitiatinnggon Devices Totallo.of Ranges No.of Air Cond. Tons No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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.No.of Devices or Equivalent OTHER: % c�^'►v kt A kc.%s: �..�.Q by r F . Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: IVOO'' (When required by municipal policy.) Work to Start: 1 t ib/ 21 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COERAGE: 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 E BOND ❑ OTHER ❑ (Specify:) I certify,under the pains` + and penalties of perjury,that the information on this application is true and complete. FIRM NAME: K.v71 S kje.,t % yr / LIC.NO.: 510 V5 E Licensee: ,M: S W04,11 Signature -- „.,.„0 ) (e...44L ti LIC.NO.: 5 1 0 y 3 E. (Ifapplicable,enter `exempt"in the license nw11ber line.) Bus.Tel.No.: '633 Soli � Address: p P d 13 Zv �� (YZG V g Alt.Tel.No.:sj40 633.tj01 R *Per M.G.L. c. 147,s. 57161,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)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No.