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Home My WebLink AboutBLDE-21-001828 Commonwealth of official Use Only .� E ' Massachusetts Permit No.0 BLDE-21-001828 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:10/7/2020 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) WILLOW ST Owner or Tenant YARM CAMP GROUND ASSOC INC Telephone No. Owner's Address C/O LEE W ERICKSON,455 QUINAPDXET ST,JEFFERSON, MA 01522-1461 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check p .40,1 ;6,, y Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd ❑ t 7 New Service Amps Volts Overhead 0 Undgrd 0 • .' e� Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel bathroom:�Y . 8,Tabe _ 8 'P. Completion of the following table may be waived by s,• . of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 4 *, Transformers • 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. 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 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 Siens 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: Edward M Lynch Licensee: Edward M Lynch Signature LIC.NO.: 35609 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 WIDGEON LN,WEST YARMOUTH MA 026733818 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:$75.00 giiiX Comnsonweafth o`fl aaaachuds116 Official Use Only/ P• ' .ft c� c'� {� Permit No. ��— l e 245 .-..- ,:it,„-? . . �GJs/oarfmsn�o�.}irs Jsrvicsa I;_ " Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTR AL WORK All work to be performed in accordance with the Massachusetts Electrical C (M 7 2.0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: YARMOUTH To the Inspe or of Tres: By this application the undersigned ' e tice . his or her.1 ten to o e lest cal wo described below. Location(Street&Number) / 1 pti4V fr i� Owner or Tenant tV 1 ` irl Telephone No. Owner's Address 6 „cc/ Is this permit in conjunctio th a bui permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building We 4-9 Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters (( New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampaclty Location and pature of Propose4 El cal Work: 6_4.---t te ci g,7,--1. 7--0 6/2/14,7 ,, Me GI,/ (,-/V 14 ' V'; 9 Completion of the followinktable may be waived by the Inspector of Wires. 'VT No.of Total ttf s No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA wl No.of Luminaires SwimmingPool Above In- ❑ No.of Emergency Lighting grnd. grad. 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 Tot 1 No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p° Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection ❑ other No.of Dryers Heating Appliances Kam' SecN * of Devicces or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent s No.Hydromassage Bathtubs 1No.of Motors Total HP Telecommunication 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: 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 BOND 0 OTHER 0 (Specify:) I certify,under the pains and p nalties of perjury,that the informer n on this application is true and complete. FIRM NAME: 1 � f IC.NO.: Licensee: c Tsai (. gnatur 0 '.�_ 4_ '�Y � /,`/ Lic.NO.:,�' cCu c r.... (If applicable, ter ' f,m�pt i the license n tuber 1 ) P r Bu . el.No.: Address: 6/� tq 96/"/ / "�' ' W 0A' / M"Alt.Tel.No. -) (( "J-of r.C.37 *Per M.G.L.c. 1 ,s.57-61, ecurity work requires Department ,f Public Safety S License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Lice see 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.