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Home My WebLink AboutBLDE-21-007593 1 Commonwealth of Official Use Only Massachusetts if� Permit No. BLDE-21-007593 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:6/29/2021 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) 4 KATAMA WAY Owner or Tenant WOLASZEK DOROTHY A(LIFE EST) Telephone No. Owner's Address C/O ELIZABETH MADISON,4 BOBCAT HILL LN,ASHLAND, MA 0172y•I� . •if Is this permit in conjunction with a building permit? Yes 0 No . 4ri x) Purpose of Building Utility Authoriza : j Existing Service Amps Volts Overhead 0 Undgr. t: ,.4 27/ New Service Amps Volts Overhead 0 Undgr. o. • Number of Feeders and Ampacity Q Location and Nature of Proposed Electrical Work: Wiring for existing garage 00 Completion of the following table may be , ,, '•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- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 12 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6 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 Data Wiring: Heaters Signs Ballasts 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 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 CommonweaUh of r'/aeeach.aedia Official Use Only On lly r Permit No. On C 1parmen o .. ire Servicede` BOARD OF FIRE PREVENTION REGULATIONS Occupancy0 and Fee Checked [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECT IC WORK All work to be performed in accordance with the Massachusetts Electrical Code(M E,5'7..C;(vJjt .QO/ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: J!t//l tf1 City or Town of: YAR MOUTH To the Inspect° of Wi By this application the undersigned gives otice his or her intention to perform the electrical work described below. Location(Street&N tuber) /j r Owner or Tenant 0 f 0 Q c P Telephone No. Owner's Address . Is this permit in conju on with pildiug permit? Yes ` No El (Check Appropriate Box) Purpose of Building //t e,/ 1 (� Utility Authorization No. Existing Service Amps 7r"/ Volts Overhead❑ Undgrd❑ No.of Meters • New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters • Number of Feeders and Ampacity /' Location and Nature of Proposed Electrical Work:lA,{I�'ec'Y -?(-1.c 7/4g /,-FS -( Completion of the followinEtable m be waived by the✓inspector of Wires. Uri Na.of Recessed Luminaires No.of CeiLS /osp.(Paddle)Fans No.or Total Transformers KVA Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA n-t.' No.of Luminaires l r o SwimmingPool Above In- No.of Emergency Lighting ¢rod. � grnd. � Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches l No.of Gas Burners No.of Detection and Initiating Devices Ili 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/AlertingqDevices No.of Dishwashers Space/Area Heating KW Local I:M Counicinnectipalon CI Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW 'No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices orEquivaleut 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: 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 El (Specify:) I certify,under the pains and enalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Signatures j LIC.NO.: 356orj (If applicable r'esegr 'in t to livens number ny) Bus.TeL No.• /L Q /�Address: /� ®/� Yirj Alt.TeL No.:777—X9---O�3�} *Per M.G.L.c.147,s.5 aI,security work requires Dep ent of Publifety"S"LiEense: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that a 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 El owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ /)S-r RECEIVED j JUN 2 9 2021 11 BUILDING DEPARTMENT Br..i'--------