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Home My WebLink AboutBLDE-22-005052 ,. *'C Commonwealth of Official Use Only Itilirt Massachusetts Permit No. BLDE-22-005052 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:3/11/2022 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) 904 ROUTE 6A Owner or Tenant Kristine Goudevin Telephone No. Owner's Address 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: A/C condenser&sub panel. 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 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 Initiatine Devices No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens 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: PAUL M RYDER Licensee: Paul M Ryder Signature LIC.NO.: 39762 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:210 WESTWIND CIR, OSTERVILLE MA 026551366 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: $50.00 •1Jç1CFR/ eg-- • 14 Cotrmronwea&.of///aesac (� ii �i cc�� cc77 Official Use Only ra, Zeparitneni oi-Vi ,•,& Permit No �i �(/ J(— -Vino ervicse BOARD OF FIRE PREVENTION REGULATIONS Reevv..Iam]and Fee Checked ' !cave blank jAPPLICATION FOR PERMIT TO PERFORM ELECTRICAL All work to be performed in accordimCe withetts WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATIO)ym Ems (MEC),Code 527 CMR 12.00 ) City or Town of: Date: — / (�- -2-�, Sy this application the undersign g vYAR of MOUbis or T HUan to To the inspector of Wires: Location(Street&Number) To the electrical work described below. I Owner or Tenant t c..p w bwoer's Address Telephone .0.147144- crew' Is this permit in conjuncts n with a building Permit? Yes ❑ No Purpose of Building �� y (Cheon Ncko.Appropriate Box) !listing Service��/� Utility Authorization , �i Amps( / d Volts Overhead 0 Und rd,� �f�--- s�--c-'s Amps / g'`� No.of Meters �` Volts Overhead❑ Und rd El No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work:11 C...n / Aur, Lis No.of Recessed Luminaires Com,letton, t ollowin table m, be waived b the I No.of Cd1.-Sasp,(Paddle)Fans `o.o IA r o Wires. lei c No.of Luminaire Outlets Transformers c No.of Hot Tubs No.of Luminaires Generators KVA Swimming Pool , ,Ye n- 'o.o 'mer en �F o.of Receptacle Outlets d' ❑ d. ❑ Bette Units cY ng No.of Oil Burners ~ No.of Switches ' No.of Zones o`j No.of Gas Burners `o.o t ` ec. nan, No.of Air Cond. o Initlatln Devices No.of Waste Disposeri 'eat amp ,am r Tons / No.of Alerting Devices Totals 2 um,-.—• ens o.o out n 10.of Dishwashers Detection/Alertin Devices Space/Area Heating KW Local❑ 'an iliT1 No.of Dryers Heating Appliances Connection ❑ Other 'o.o "a rn y Heaters KW 'O.o •o.o KW • No.of Devices or uh'alent S, s Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Motors a No.of Devices or • ,nivalent OTHER: Total HP ecommun na f gg No.of Devices or E,uivalent Estimated Value of Electrical Work: Q eti Attach additional detail tjdesired,or as required by the Inspector of Wires. Work to Start: 3 �.// - .t,♦ (When required by municipal policy.) WrktINSURANCE COVERAGE: . Inspections n ape lived to be by eere requested accordance with MEC Rule 10, tho COVERAGE: proof of liabilitypermit for theeo and upon work issueayti insurance including co lido I� or itsel subs al work may nt. unless undersigned certifies that such coverage is inoperation"coverage substantial equivalent. The CHECK ONE: INSURAN g force,and has exhibited proof of same to the permit issuing office. I ctirtlfy,under file / CE� BOND ❑ OTHER ❑ (Specify:) FIRM NAME: d allies ofperjpry'that the info allon�n this appJ'eolfon is true and complete (/f applicable.enr �.�51gna re LIC.NO.� Address: ' r' i the It use number line.) LIC.NO.:? ) *Per M.G.L.c. 1 7,a.57-61,security work �`/ C Bus.TeL No OWNER'Scense: Lic.No. INSURANCE WAIVER: I am requires Department of Public Safe g•, Alt.TeL No. tJ 66 ?A( wnreqner/by law. Bymysignaturethat the Licensee does not have the liability insurance coverage no lly Owner/Agent below,I hereby waive this Signatureir` �t• I am the(check one • Telephone No. ownerowner's a.ent. PERMIT FEE:$