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Home My WebLink AboutBLDE-23-002502 . tti,, Commonwealth of Official Use Only ��. Massachusetts Permit No. BLDE-23-002502 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) 10 GASLIGHT DR Owner or Tenant WILSON EVERETT J Telephone No. Owner's Address WILSON MELISSA,49 CLINTON AVENUE, DOBBS FERRY, NY 10522 Is this permit in conjunction with a building permit? Yes ❑ 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 sunroom Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 1 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 6 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 3 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 ❑ 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: EDWARD M LYNCH Licensee: Edward M Lynch Signature LIC.NO.: 35609 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 WIDGEON LN, WEST YARMOUTH MA 026733818 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: $75.00 (((g(72V h.vA,� )2/ZL/2 41,2. R'ECE��IVED NOV 07 - a/, �yy� Commonwea(1h oif rrlaasachueelle cral Use Only,rW. 1�' �T7 BUILDING D:,`' +'lG�,E"yy"i cc//,, �c77 Permit No. . 'Z. `C Z- sY: :�' �•"`-1i- 2 pariment el. tee�ervtcee BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked '::V.'" [Rev.l/07] (leave blank) ' APPLICATION FOR PERMIT TO PERFORM ELE TRI AL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M ),527 12,({0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: )$ . City or Town of: YARMOUTH To the Inspe for o Wires: ty this application the undersigned give notice f his 9r h i lion to perform the electrical work described below. Location(Street&Number) 0 L �. Owner or Tenant Fi/.P�� /, ' /01 Telephone No. Owner's Address ..q/,;AL Is this permit In conjunctioLt th tabu ng permit? Yes No ❑ (Check Appropriate Box) Purpose of Building i, (' d/�, l i �J! f Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampaclty • iocation and Nature of Proposed Electrical Work: Si, Completion ofthefol/owingroble maa be waived by the/n�ecror of Wirer. Lb: No.of Recessed Laminairea No.of Cell.Sasp.(Paddle)Fans l/ No.of Total / Transformers KVA n No.of Luminaire Outlets No.of Hot Tubs Generators KVA 4' No.of Luminaires Swimming pool Above in. No.of asmergency Li7shng ( ¢rod. crud. Battery Units „' No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Detection and No.of Gas Burners 1;r r� Initiating Devices No.of Ranges No.of\Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposer Heat Pump Number,Tons,,. KW. "No.of Self-Contained Totals: -- Detection/Alertlng,Devices No.of Dishwashers Space/Area Heating KW ` ai 0 Municipal No.of Dryers Heating Appliances KW Security Systems' ou Othn No.of Water KW No.of No.of No.of Devices or Equivalent Data Wiring: Heaters Signs Ballasts No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent Telecommunications Wiring: OTHER: No.of Devices or Equivalent Estimated Value of E ec cat Work: Attach additional detail if desired,or as required by the Inspector of Wires. (When required by municipal policy) Work to Start: // Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO : 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 ID(Specify:) I certify,under the pains and nelties ofperfcry,that the Information on this application is tr e and complete. FIRM NAME: f Licensee: - / - Al LIC.NO.: (If applicable ar pt,•i Inc.)- Signature 1 i . : .. A�./.� LIC. No. �j J Address: ,_ I Bus.Tel.No.. 111. •Por M.G.L.c. 47,s.S -6 ,s curity ark requires s eparhnent if•ubnc/., . ieAenl Lie.No. // JJ OWNER'S INSURANCE AiVER: I am aware that the Lie. sec 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE:$ . __ . -• 7.4 ' • • • I I _ - - _ . - - • • • , -