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Home My WebLink AboutBLDE-22-0000557 Commonwealth of Official Use Only t_. 't ! Massachusetts Permit No. BLDE-22-000055 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:7/6/2021 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) 22 WHITES PATH Owner or Tenant DAVENPORT DEWITT TR Telephone No. Owner's Address DAVENPORT REALTY TRUST, 20 NORTH MAIN ST, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 . No ❑ (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: Upgrade lighting 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 I 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 No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Paul M Morris Licensee: Paul M Morris Signature LIC.NO.: 17520 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 213,1 COUNTRY WAY,SAGAMORE MA 025610213 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 Signature Telephone No. (PERMIT FEE: $80.00 ammonwealth o!Yi/addach dead Official Use Only Zepurtrnent of moire Serviced Permit No.�Z _�� rj I-_- 5 - �, ;: BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked APPLICATION FOR PERMIT ® [Rev.1/07J (leave blank) All work to be performed in aceordance with the Massachusetts PERFORM c1�ELECTRICAL WORK _ (PLEASE PRINT MINK OR TYPE ALL LVFORMATIOII) Date: (D ,527 CMR 1Zoo City or Town of: Z--�i- Zo'Z� - By this application the undersign_yet...... .__________ � Toy Inspector of - eu gives notice of his for her intention to o tress Location(Street&Number) _t' Penn the electrical work described below. Owner or Tenant Owner's Address g Telephone No. — Is this Permit in conjunction with a building permit? , ❑Na (Check Appropriate Box) Purpose of Building Existing ServiceUtility Authorization No. Amps ' / Volts Overhead 0 Undgrd ❑ N w 'ce �' No.of Meters Amps I Volts Overhead 0 Un rd - Number of Feeders and Ampacity ❑ Na of Meters Location and Nature of Proper Electrical Work: • Fir No.of Recessed Luminaires Com,Woo o the followk table to• be waived b the 1 r- for of Wires. 'o.o a No.of Cell.-Susp,(Paddle)Fans No.of Luminaire Outlets No.No.of Hot Tubs KVA Na.of Luminaires Generators KVA • No.of Race �g Pool ,, ' 'Ye ❑ a. ,o.o m Receptacle Outlets Bathe Units i' ` • g No.of Oil Burners ad. No.of Switches FIRE ALARMS No.of Zones No.of Gas Burners • •' 1 o.of I etectton and No.of Ranges . Inftiatin, Devices No.of Air Cond. eta No.of Waste Disposers `eat Pumpum, Tons No.of Alerting Devices No.of Waste skiers Totals: " er on----S--- �' De o -Conte ned 'Local ionlAlertin-Devices No.of Space/Area Heating KW "o.o -ice Bleating A Local 0 Co cipa a ❑ Other Appliances $ter �r �^'� No.g Heaters KW O.o Ivan 'ces or E trivalent Si.: Dat • a 'omessage Bathtubs No.of Motors asts Na of Devices or E trivalent OTHER: Total®P eleconnm cations tiring. Na of Devices or ,,trivalent Estimated Value ofElectrical Work Attach additional detail ifdesired,ores INSURANCE to Start: TnspectiQ (When required by municipal policy-) Work �na�by the Inspector of Wirer. SURANCE COVERAGE: Thiess requested in accordance with MEC Rule 10,and the licensee waived by the owner,no upon completion.provides proof of liabilitypermit for the performance of electrical work may issue unless the licensee provides ies that such insurance including completed coverage is in force,and has exhibitedoperation"coverage or its substantial equivalent The CHECK ONE: INSURANCE proof of same to the I cet7 ,un�. BOND ❑ OTHER 0 (Specify:) permit issuingoffice. FIRM NAME: Pains and penalties ofper�uty,that the information on this application is trite and complete Licensee:7¢ 4_ LYC.NO.: (jfaPPticablenter" n � Signature' Address: K5# 2'in license number line) LIG NO.:/'73�-- �Per M.G.L.c.147,S.57-61,security• err $�3 Bus.Tel.No.: �$--77�k /`?y. INSURANCE W Department ofPublic SafetyMt TeL No.: OWNER'Squired law. By �R: I am aware that the Licensee does �Q bill ran coverage Owwner/Agent �`signature below,I hereby waive this not have the Iiability insurance Signature Nirement I am the(check one) $ ownernonnaIly owner's. : ,,t.Telephone No. PP% FEE:$ i p 1 .l s:.c. C'._By "tvi . o "�' O �.