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Home My WebLink AboutBLDE-23-004836 Commonwealth of Official Use Only _' Massachusetts Permit No. BLDE-23-004836 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:3/3/2023 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or intention tgo�perfothe electrical work desibed below. Location(Street&Number) , C W R ItAY/�//•�/Jlp (/�pxzs Owner or Tenant PAMPOSH USA INC 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: In-Ground pool. (Grounding done by others) 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 Initiative 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 ❑ 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 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: TYLER W PAYNE Licensee: Tyler W Payne Signature LIC.NO.: 22091 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:5 JANS PATH, HARWICH MA 026452458 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: $85.00 s_...—c_7( 9 -Y7H6s- --ec) Commonwealth of Massachusetts 0t,.,a n' . ` ! Permit No. Z 01 Department of Fire Services Occupancy and He Checked %,4. : BOARD OF FIRE PREVENTION REGULATIONS IRev 9/051 (lease blank) APPLICATION FOR PERMIT TOPERFOR�M ELECTRICAL WORK accordanceAll work to be performed in as (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 3 PA 01o42;_ City or Town of: Yoariskov4L, To the Inspector of Wires: By this application the undersigne gives notice of his ot her` intention to perform the electrical work described below. Location(Street&Number) O. Q. rVIC IN'\: s G(Ca- Owner orTenant�0►W%.e So VcJgs, �. Ac_ Telephone Noi1Lj. O9.3916 Owner's Address t 5�1AC\o It* 'Q& c1` If.e Mo•xr y M4 O/SW - Is this permit in conjunction with a building permit? Yes)I2 No ❑ (Check Appropriate Box) Purpose of Building :DlANel .t' Utilits'Authorization Na. Existing Service)t%C Amps /Zv I Volts -Overhead E Undgrd, No.of Meters / 1 New Service Amps _ I Volts Oscnccad E Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Elects 1 Work: W t,�t 00r 4 IJ i �,. rt-- T /0D� a TQ Completion of the followings tble loan be waived by the/ns ector of Wipes. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.ot Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners -No.of Detection and No.of Switches Initia j Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges fans Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Municipal Other No.of Dishwashers Space/Area Heating KW Local❑ Connection Heating Appliances KW Security S stems:* No.of Dryers No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromacsage Bathtubs No.of Motors Total HP Telecommunications Wiring:No.of Devices or Equivalent OTHER: /-�Jy) attach additional detail if desired.or as required by the Inspector of Wires Estimated Value of i trical Work: J'�" (When required by municipal policy.) Work to Start: /23 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE VERAGE: Unless waived by the tnvner,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 Zi BOND 0 OTH}R 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME:PAy NE F.LECTRIC I I NG LIC.NO.:630L' -$ Licensee: T'iLE W• PA\INE Signature kji.& LIC.NO.i22OA —A (If applicable,enter"r_rernpt"in the license number lace.) 1'{"' II Bus.Tel No. e P& Address: P.0. BOX d1 ScU' H t-t et tun ,M A OZt0l I Alt.Tel.No: r i :y *Security System Contractor License required for this work;if applicable,enter the license number here: 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.l hereby waive this requirement. I am the(check one)0 ow ner ❑owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.