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Home My WebLink AboutBLDE-23-000914 Commonwealth of Official Use Only '+ Permit No. BLDE 23-000914 0E ,, Massachusetts :' 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:8/22/2022 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) 904 ROUTE 6A Owner or Tenant BRUCE GOODWIN 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: Miscellaneous work per attached. Completion of the following table may be waived by the Inspector of Wires. 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 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. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices Space/Area HeatingKW Local ❑ Municipal 0 Other: No.of Dishwashers P Connection HeatingAppliances No.of Dryers PP 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 Telecommunications Wiring: No.IIydromassage Bathtubs No.of Motors Total HP 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: PAUL M RYDER LIC.NO.: 39762 Licensee: Paul M Ryder Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:210 WESTWIND CIR, OSTERVILLE MA 026551366 *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 'PERMIT FEE: $75.00 I Signature Telephone No. askyiyi trri41 I c �'o `3 p ON 1"1� t-f(A- 6(3 C FINTP-t-- 4 L RECEIVED ,Z 4j AUG 18 /(�7? au / (nomnwntveatth of//Iaeeachuea(ie Official Use Only K ," -;4r:UILDING DEP,4 ,AE_NT cc--�� 22 / (() 1 id', 6Y ,_ id o�.,}ing Sirvicsa Permit No. ��_7.y V e; 1 f._ ` Occupancy and Fee Checked v BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07] (leave blank) 1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1 i Z Z_ City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned ivies notice of his or her intention to perform the electrical work described below. Location(Street&Number) if Owner or Tenant r Telephone N� 40') t , ,/r 0 Od( Owner's Address c„....)t^4.,. - o' I- d-0,,% Is this permit In conjunc n with a building permit? Yes El No A. (Check Appropriate Box) Purpose of Building J r r .‘ C,..... Utility Authorization No. I\ Existing Service jut Amps / Volts Overhead❑ Undgrd❑ No.of Meters / \l) New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty Location and Nature ooff/Propposed Electrical Work: j/A "c� I- #t, ,t�j'^ ) f^J ,..h-_ /. -mzir c.p 1- Lrles-at Com tenon of the following table may be waive y the ns, etor Tres. t!f No.of Recessed Luminaires No.of Cell.-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 grad. grad. Battery Units tt 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 1..? No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number.,_Tons_._.KW.......... No.of Self-Containea Totals: ...." Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Mun Connection ❑ Othq• 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: �p � ay Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Wo :/d. ) v (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE G : 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 an enal es of perjury,that t information n this i pplication is true and complete. FIRM NAME: & .e c.- r..►I v! LIC.NO.3e/ 7 6 L C. Licensee: i ,A-t 4 f� 7�-uT ignature �f LIC.NO.:Addr(If ss: 0e• "exe t"in(I e 1-icense n l�r lip...-V(/� 0 6 l/rl�r Bus.Tel.No 66 3 Address• r / /fr_- Alt.Tel No • *Per M.C11.L.c. 147,s.57-61,security wo requires Department of Public Safety"S"License: Lic.No. 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 0 owner's agent. Owner/Agent Signature Telephone No. 1 PERMIT FEE:$