HomeMy WebLinkAboutBLDE-23-002640 a
Commonwealth of Official Use Only
et Massachusetts Permit No. BLDE-23-002640
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
f 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:11/14/2022
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) 43 PLEASANT ST
Owner or Tenant KARYN WILSON Telephone No.
Owner's Address 43 PLEASANT ST, SOUTH YARMOUTH, MA 02664
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: Wiring for exterior kitchen.
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
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 ❑ 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: 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) 0 owner ❑ owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $75.00
avvoui r
2
RECEIVED
. ry�
'1 NOV 10 2022
• M.w rr/aeeac�iuudie Official Use Only
. y gU EGING D _ ' /
o'"'` e CC-/l/i Permit No(�23 _ "I"'0
'I. ■,.a. Y O JW /N1r/0
"s Occupancy and Fee Checked
.sli. BOARD OF FIRE PREVENTION REGULATIONS [Rev.I/07] (leave blank)
N APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be Performed in accordance with the Mas6achusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7/ /(.)- Z 2i
City or Town of: YARMOUTH To the Inspector of Wires:
t By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
\ Location(Street&Number) «f^,,,t
Y Owner or Tenant , j '5-----
Owner's Address ��y I(Jo'r / t Telephone No. c
LST'vi.)
Is this permit in conJuo on with a building permit? Yes No
(Check Appropriate Box)
yt Purpose of Building �4/„\ ( Utility Authorization No.
(N-
Y Existing Service Amps2,O 0/ Volts Overhead Elrd Undgrd ElNo.of Meters
New Service Amps / Volts Overhead❑ Und rd
g ❑ Na.of Meters
Number of Feeders and Ampacity -
ation and Nature of Proposed Electrical
Work:�N '�--/-- /tr- /.�
c D(�l f a �` G �i T ^C. 1-Y.l G,..--ix'tit I, -‘c(,
vl
li�' Cam teflon oft followingroble may e i ived dy the Ins etor of Wires. C
t No.of Recessed Luminaires N f KVA•
t No.of Luminaire Outlets No.of Hot Tubs
Generators KVA
Pool Above In- No.of Emergency Lighting
4' No.of Luminaires - Swimming
„
• ' No.of Receptacle Outletsgr0d' grnd. Battery Units
No.of OB Burners FIRE ALARMS INo,of Zones
No.of Switches No.of Gas Burners No.of Detection and -
1 t r No.of Ranges Initiating Devices
tot
No.of Air Cond. al
Rest Pam Tons No.of Alerting Devices
No.of Waste Disposersp Number Tons KW 'No.of Self-Contalued
Totals. _- Detection/Alertin Devices
No.of Dishwashers Space/Area Heating KW Local un c pa
No.of Dryers Connection °dim
rY Heating Appliances KW ecu ty ystemcs:
o.o Heated KW 0.° o.o No.of Devices or E uivalent
Si na Ballasts Data Wiring:
No.Aydromaaaa a Bathtubs No.of Devices or E uivalent
g No.of Motors Total HP a ecommun ca ons r rag
OTHER: No.of Devices or E uivalent
D O (Al Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work:
Work to Start: ct-'ZZ (WhC0 required by municipal policy.)
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 (Specify:)
I certify,under 701ns and nalties o
FIRM NAME: fPerlur!',thatf inforrmatimation on this application is true and complete.
C74 a / A Li 2- C(r� _
Licensee: t/ f y D Ell Signature
NO.: ��' --�-
Of applicable,emef ex mum to the hcenre number line./ SlgoatUre�n�r LIC.NO.. / /V L
Address: Bus.Tel No/���� p —'Per M.G. is. Alt.Tel.Noky�"'7 TTd"' (`2/
security work requires Department of Public Safe
OWNER S INSURANCE WAIVER: t Safety"S"License: Ltc No
Bymy signature below,6 hereby waivevtthis requirement trot
am the(ve check one e liability i•owner
Coverage normally
---
OWNER by law.
Owner/Agentowner
Signature •owner'sa•ent.
Telephone No.