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Home My WebLink AboutBLDE-23-001168 Commonwealth of Official Use Only 'il N\ Massachusetts Permit No. BLDE-23-001168 23 001168 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), M (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: YARMOUTH Date:To the Inspec22 By this application the undersigned gives notice of his or her intention to perform the-electrical work described below.tor of Wires: Location(Street&Number) 126 THACHER SHORE RD Owner or Tenant PERERA PHILLIPS JR TR Owner's Address PERERA FREDERICA P,40 EAST 94TH ST APT 30A, NEW YORK, NY 10128 Telephone No. Is this permit in conjunction with a building permit? Purpose of Building Yes CINo CI (Check Appropriate Box) Existing Service Amps VoltsUtility Authorization No. p Overhead ❑ Undgrd ❑—^-- New Service g No.of Meters Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Closet light&bed room fans. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 2 No.of Transformers Total KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- g rnd rnd. ❑ ❑ No.of Emergency Lighting No.of Receptacle Outlets No. . Battery Units of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges Initiating Devices No.of Air Cond. Total Ton No.of Alerting Devices No.of Waste Disposers Heat Pump Number 'Tons KW• No.of Self-Contained Total: — No.of Dishwashers I •t•cti i • •rti . Devi •s Space/Area Heating KW Local ❑ Municipal No.of Dryers , cti n I] Other: Heating Appliances KW Security Systems:* No.of Water KW No.of ,1. If Devi •s o _ • ivale I t Heat•rs No.of Ballasts Data Wiring: i.ns No.Hydromassage Bathtubs Ni. If_i evi e o r E•uival•it No.of Motors Total HP Telecommunications Wiring: OTHER: o. i f_Ievi •s •r •uival• •t Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work to start: (When required by municipal policy.) 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 I certify,under the pains and penalties o (Specify:) fperjury,that the information on this application is true and complete. FIRM NAME: PAUL M RYDER Licensee: Paul M Ryder Signature LIC.NO.: 39762 (If applicable,enter'exempt"in the license number line.) A Address:210 WESTWIND CIR, OSTERVILLE MA 026551366 :: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Allt.t. Tel.Tel.Noo..: 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. t PERMIT FEE:$50.00 6-etc . 9 /7/2v REC1 WED c \ww EP P O 1 2022 •.uGRU aeeaCh ueatle ffiCIaI Use �23-(�■ ,,,�/ PCrnitNo.`�o n t. y;a ING LJEPARTME ',adman'ol}irs urea' V. '"` ' • - PREVENTION REGULATIONS Occupancy and Fee Checked Rev. 1/07] l ---- cave blank ( APPLICATION FOR PERMIT TO PERFORM ELECTRICAL ►w' All work to be performed in accordance with the Massachusetts Electrical Code r r OR K (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) E�), 27 CMR 12.00 City or Town of: YARM orTH Date: •LZ-- By this application the undersigned gives notice intention to perform the electrical To the work describedc or of Wires: pec (Street&Number) below. t--- Owner or Tenant y/' p k �c v"� /�,( Telephone No. Owner's Address w " r d z.ytr(, Is this permit in conjunction with a buil ng permit? Yes ❑ No gi Purpose of Building 47� (Check Appropriate Box) 1 Existing Service Utility Authorization No. Amps / Volts New ce —""'—'-'— Overhead 0 Undgrd 0No.of Meters Servi Amps / Volts — Number of Feeders and Ampacity Overhead[] Undgrd 0 No.of Meters E Location and Nature of Proposed Electrical Work: ‘r i al �N n .i o'(r-c .' C.- .1-t A kk...c om.letion o the ollowin_ table m be waived b the In .ect o Wires. i' No.of Recessed Luminaires No,of Ceti.-Sns . `o.o '=:t No.of Luminaire Outlets p (Paddle)Fans KVA No.of Hot Tubs Transformers No.of Luminaires Generators KVA Swimming Pool ,rnd.love ❑ n- 0 '0.o mergency g n M` No.of Receptacle Outlets °d Butte Units g �. No.of Oil Burners FIRE ALARMS No.of Zones 'h_ No.of Switches No.of Gas Burners `o.o etec on an `1' No.of Ranges Initiatin Devices No.of Mr Cond. ota No.of Waste Disposers Tons No.of Alerting Devices 'eat 'um Totals: Ut° er ons " `o,o e - onta n a No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW 'un cr No.of Dryers Heating Appliances Local Connection � Other "o.o "a er KW ecu ty ystems: Heaters KW o o .o o No.of Devices or E uivalent Si,us Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Devices or E.uivalent No.of Motors Total HP a ecommun car ons " r ,g: OTHER: No.of Devices or E.uivalent �' Attach additional detail ifdesired.or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start; -==---_ (When required by municipal policy.) INSURANCE 2 Z Inspections to be requested in accordance with MEC Rule 10, GE: Unless waived by the OCT,wn 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. Theand upon completion. undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing CHECK ONE: INSURANCE ( OTHER 1 certify,ender the psi sand pens/ties fpe o BOND (Specify;) office. FIRM NAME: an Zrfury,that the information on this application is t tie and complete. .e...-- ,� Licensee: �.- L LIC.NO.:(If applicable ter"ex mpt"in t e license number It e.) S gnature �- Address: �Jr/ g / LIC.NO.- t *Per M.G.L.c. 147,s.57-61,security work requires a Bus.Tel.N . OWNER'S INSURANCE WAIVER: Department of Public SafetyAlt Tel N `� / required b law. By I am aware that the Licensee does not havehe liability insurance overage normally Y my signature below,I hereby waive this requirement. I am the(check one ■ owner • owner's a:ent. Owner/Agent Signature Telephone No. PERMIT FEE:$