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Home My WebLink AboutBLDE-23-004065 Commonwealth of Of Use Only 0 �� Massachusetts Permit No. BLDE-23-004065 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:1/24/2023 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) 35 KNOLLWOOD DR Owner or Tenant LYNSKY MARK V TRS Telephone No. Owner's Address B M L REALTY TRUST, P 0 BOX 617, YARMOUTH PORT, MA 02675 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: Lighting, receptacles&switching as noted on attached. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 19 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 4 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 10 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 1 Space/Area Heating KW Local ❑ 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: Stephen M Peckham Licensee: Stephen M Peckham Signature LIC.NO.: 17326 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 367, CENTERVILLE MA 026320367 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 Qt'Urrett 4 jiy_d 51/2-412-3 1.- (N904,51C--tc0 "1.4. 7/Set-ic*I. MOT 0 1 AO L Lle if."-C) ee—tome CiLi,n. ./ 74 RE,. CEIVED r JAN .... . CO nnOUltaa 7C M 6AashA44.ita Officiali Use Onlyy L c-� {� Permit No. �2 `'1 k�5 B U I L U 1 N i r:' EN-1 2eparfmsni O/._i`ire.Jsrvics6 By ___-., ' ' —_ Occupancy and Fee Checked - ,,, ,/ ;*ARE) OF FIRE PREVENTION REGULATIONS [Rev. I/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Maasachusetts Electrical Code(MEC),5 7 CM 12.00 e (PLEASE PRINT IN INK OR TY E ALL INFORMATION) Date: i `, City or Town of: k W.470\ To the Inspector f Wires; By this application the undersi gives notice of his or her intention to perform the electrical work described below. Location(Street&Num er) . rJ I C N w c,L'_,_ r V kk &(.-' . t '1 u 0 Owner or Tenant Telephone No. �?t' �-3 E ` i ' C Owner's Address Is this permit in con t unction with a buiidingapermit? Yes g No ❑ (Check Appropriate Box) Purpose of Building v .i 6. R eke(L -€ Utility Authorization No. Existing Service )L Amps / Volts Overhead n Undgrd C No.of Meters i New Service Amps / Volts Overhead❑ Undgrd C No.of Meters Number of Feeders and Ampacity ' Location and Nature o Proposed Electrical Work: We(- •.. ��1 /A0 (J I l2�(: 'yL��gJ�, e)L� t vkj Completion of the following table may be waived by the Inyaector of Wires. Total lit ( Transformers KVA CZI No.of Luminaire Outlets No.of Hot Tubs Generators KVA # ! No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grad. grnd. Battery Units No.of Receptacle Outlets '1 No.of Oil Burners FIRE ALARMS No.of Zones It No.of Detection and No.of Switches 10 No.of Gas Burners Initiating Devices Total I'Li No.of Ranges f� j No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers i Space/Area Heating KW Local❑ Connection ❑ other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent rData Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsofDevices r EquWiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of le_c ical Wo 0,-, (When required by municipal policy.) Work to Start: 1 ri. '3-..i 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 ❑ OTHER ❑ (Specify: ' I certify,under t#cpairts and pen es of perjury,that the information n ' pplication is true and complete. _, FIRM NAME: 'f kf%-;\ (c'(%� "l tito, LIC.NO.: IC C' 7 ) C. Licensee: ` i‘ .` Signature _ LIC.NO.: 73 (If applicable-enter"exem t"in,tbe lice number tine.) Bus.Tel.No. L,-I.\.) I Address: (-C C�' 1t.' ,q L.n li, t t +) '1`'S' t( Alt.Tel No.: *Per M.G.L.c. 147,s.57-61,security yfork requires Department of Public safety"S"License: Lie,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 ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ 7S-