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Home My WebLink AboutBLDE-23-002504 6I ,� Commonwealth of Official Use Only 1. .' Massachusetts Permit No. BLDE-23-002504 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:11/7/2022 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) 12 MOHEGAN LN Owner or Tenant MICHAEL GRILLO 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 ❑ 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: Miscellaneous work per attached. 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. Total No.of Alerting Devices g No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 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.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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 ❑ 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 It q 6" Commonwealth 0/Mamacki et Official all Use Onl v _- .r cc�� cc77 Permit No. li�J ' �� c 2)8partment o/.}ire�erukeJ °t i- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / 7 Z 2. City or Town of: /t- a„ t To the Insp cto of Wires: By this application the undersigned ves notice of his or her intention to perform the electrical work described below. Location(Street&Number) /) rii o 4 G / c Owner or Tenant i`1/7it°4 L / cj h;7/d Telephone crae'"� -.j f f'j`�e Owner's Address S',,¢7,,_ / Is this permit in conjunction with a building permit? Yes ❑ No ,® (Check Appropriate Box) Purpose of Building / S,elf co Utility Authorization No. Existing Service /r Amps / Volts Overhead a Undgrd❑ No.of Meters / New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity , �/ Location and Nature of Proposed Electrical Work t,-c �j. ,zJ�,-, ��'/ b �C,�h A g €-,,e i 5 Tln C,5 l--L 4, ,-7-) 97-17 e/ .77., ? �z" / "`% < `i�j 4 ,' ^iI L ) /A,�/'� Completion of the following table may be waived by the Inspe for of Wires. Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf 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 Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Di Municipal ❑ Other 1 Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of KW Heaters Signs Ballasts No.of Devices Wiring: evices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: iop Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of E ec 'cal Work: . 197f6 (When required by municipal policy.) ) Work to Start: / Z - Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE GE: 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 ❑ OTHER ❑ (Specify:) I certify, under the pa s and penaltiey of perjury,that the informatio on this application is true and complete. FIRM NAME: pa' /: 1 ,, tr.'L..-/ ,if v/ y- LIC.NO.:, Licensee: /-r/L Signature✓"( g ,e,-/( �J LIC.NO.(If applicable, ter "exempt"in the license number line.)Address: C Bus.Tel.No�tt,&) Z p?o /l3 I *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Alt.Lic.NoTel. o.( "� bCy 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,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $