The URL can be used to link to this page

Home My WebLink AboutBLDE-22-002470 "co.._- Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-002470 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) D ate:10/30/2021 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 FROTHINGHAM WAY 1`,��?) ¢: Owner or Tenant BASS RIVER YACHT CLUB INC Telephone No. Owner's Address PO BOX 182, SOUTH YARMOUTH, MA 02664-0182 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: 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 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.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: Richard W Crawford Licensee: Richard W Crawford Signature LIC.NO.: 13923 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 84 CRANBERRY LN, S YARMOUTH MA 026641005 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: $100.00 ' 3-t=8i- 4- Co - ,/(./.( I, Feod Lt tC1 r--- ;RECEIVED � �, aa`` I OCT 29 ? ?1 tilt* Commonwealth oil/lladdachadette / O}icinl I N Only � cc�� cc77 BUILDING DEPARTMENT 1107 •••.," � spartment Permit No, tea" `` i1 54 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee ChecTceda� �° [Rev. 1/07] (leave blank) 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) City or Town of: v UTH Date: f By this application the undersigned giv notice his or her intention to perforTo m theI ensp lectrical work ector of ires described bel Location(Street&Number) Z.Z.- ow. a L Owner or Tenant '' �-.- �_i __ �['�� Telephone No. Owner's Address Is this permit In conjunction with a building permit? Yes ❑ No•-�✓e � � ' _ t3 (Check Appropriate Box) Purpose of Building = -� �4 Utility Authorization No. Existing Service. Amps / i Volts Overhead❑ Undgrd No.of Meters cystic.. _ NewNew Service Amps / Volts Overhead Number of Feeders and Ampacity Ell Undgrd [] No.of Meters Location and Nature of Proposed Electrical Work: Lo w f,lCom,letion a the ollo •in: table m, be waived b the Ins,ector o Wires. No.of Recessed Luminaires No.of Ceil: p Sus . (Paddle)Fans '°•° ota ; No.of Luminaire Outlets Transformers KVA ,_'vNo.of Hot Tubs Generators KVA • 'ove No.of Luminaires Swimming Pool ❑ n- 'o.o mergency g mg rod. No.of Receptacle Outlets nd. Batte Units No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners `o.o it etechon an, ` No.of Ranges Initiatin. Devices No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers 'eat ump `um i er ons ' ►' o e - onta ne Totals: o. No.of Dishwashers Detetection/Alertin 1 Devices Space/Area Heating KW Local❑ Tun ctpa No.of Dryers Heating Appliances ecun No. `o.o "a er KW ty ystems: Heaters KW ° ° •o o No.of Devices or E.uivalent Sins Ballasts Data Wiring: No.of No.Hydromassage Bathtubs No.of Motors e ecommun ca onsE•'rmalent Total HPg OTHER: No.of Devices or E,ulvalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: Z/ (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C V 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 fit BOND 0 OTHER I certify,under the pains and penalties o (Specify') m4 �. fperjury,that the information on this application is true and complete FIRM NAME: IA s `��[(vf� Cr LIC.NO.: �L_ Licensee:(If ni �A — Signature.' /�— �..,p, in me license number line.) "�"� — LIC.NO.: _ Address: *Per M.G.L. c. 147,s. 57-61,security work requires De Bus.Tel.No.:cla 7k 7l1r r,J OWNER'S INSURANCE WAIVER; Department of Public Safe Alt.TeL No,: I required bylaw. I am aware that the Licensee does not have he liability insurance overage normally By my signature below,thereby waive this requirement. I am the(check one [] Owner/Agent Signature owner � owner's a.ent. Telephone No. PERMIT FEE:S bV D