The URL can be used to link to this page

Home My WebLink AboutBLDE-21-004895 Commonwealth of Official Use Only i- ,I Massachusetts Permit No. BLDE-21-004895 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:3/1/2021 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) 10 ATLANTIC AVE Owner or Tenant VIRTOM LIMITED PARTNERSHIP Telephone No. f\ Owner's Address 2 ATLANTIC AVE, SOUTH YARMOUTH, MA 02664 /O ) Z� Is this permit in conjunction with a building permit? Yes El No 0 (Chec rope A411 Purpose of Building Utility Authorization No. Z Existing Service Amps Volts Overhead 0 Undgrd 0 �,, s 1114 4, At New Service Amps Volts Overhead 0 Undgrd 0 No -�1�� Number of Feeders and Ampacity U,r4 ` Location and Nature of Proposed Electrical Work: Replacement panel. Completion of the following table may be waived by the Ins,40. 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 0 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 HeatersWater KW No.of No.of Data Wiring: 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: Licensee: Shawn Micheal Ricard Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 22895 Address:27 Ba ywood Drive, Orleans MA 02653 Bus.Tel.No.: 7748012921 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 9788157031 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 ❑ owner's agent. Owner/Agent Signature Telephone No. (PERMIT FEE: $80.00 I Commontvsa[h o`Madeae/uj s.(d Official Use Only ,, 6 95 et U' 2spa+t~msniot ire.gervieed _ .1i Occupancy and Fee Checked , . BOARD OF FIRE PREVENTION REGULATIONS 1/4 [Rev. 1/07) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M§C),527 C R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: a l a S a 1 City or Town of: YARMOUTH To the Inspector of ires: By this application the undersigned gives notice f is or her intention to perform the electrical work described below. Location(Street&Number) /U /0 y)/IC 41,e Owner or Tenant / ve ire GLi Telephone No. Owner's Address /U 14 f/G,7 t/C /se Is this permit in conjunction with a building permit? Yes El No 0 (Check Appropriate Box) _S Purpose of Building ij p Utility Authorization No. Existing Service;�CRC Amps /do /-A cc Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: Pa#ie/ Rep'4 rennervt ... Completion of thefollowinktable may be waived by the In vector of Wires. No.of Recessed Luminaires No.of Cell.-Snsp.(Paddle)Fans No.of al Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting and. Erns. ❑ Battery Units �t No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones v. No.of Switches No.of Gas Burners No.of Detection and_ t,,r Initiating Devices No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons RW No.of Self-Contained Totals:I_ �. .""�µ"' '�" '" Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Monnectunnut� Cion ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent No.of Heaters Signs Ballasts Data Wiring:, No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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: Inspections 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 d penalties of pe ury,that the information on this application is true and complete. FIRM NAME: 5hu c�n IV:Ca LJ rd 1°C*r'C 2toc LIC.NO.:A �. gq 5 Licensee: ,S17 C U/h tet{A cc/ Signature � E O ti S I (If applicable,enter"exempt"in the license number line.) / nf�i LIC.NO.: t 7�y ira Address: Bus.Tel.No.: / a 9a t TeL No *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: AIL 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,1 hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$