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Home My WebLink AboutBLDE-22-004874 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-004874 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.1/07j 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:3/3/2022 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) 197 PINE GROVE RD Owner or Tenant Mike Madden Telephone No. Owner's Address Q Is this permit in conjunction with a building permit? Yes❑ Na 0 (Checll/hjtp p Purpose of Building Utility Authorization No. ``^�r..j Q Existing Service 100 Amps Volts Overhead 0 Undgrd 0 `v to New Service 200 Amps Volts Overhead 0 Undgrd 0 N s Number of Feeders and Ampacity /\ Location and Nature of Proposed Electrical Work: Upgrade service. /_O) Completion of the following table may',yireedd or of Wires. No.of Recessed Luminaires No.of Ceil.Susp.(Paddle)Fans No.of / // 1 Transformers / A No.of Luminaire Outlets No.of Hot Tubs Generators 7SJKVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. 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 Initiation Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices o No.of Waste Disposers Heat Pump Number Tons 1 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: jjgaterg ___.$inns ___moo.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:$50.00 CS ( LM � ) RECEI '4D Commonwealth Vaeeachueetie Official Use Only MAR 0 3�� '•=�:•.'"c� cc�� 77 nj211.1 7 I -�,:� �(ls/oartnrsnt o� }l,y Ju�vicse Permit No. .1-. ` BOA Occupancy BUILDING DE A. T RD OF FIRE PREVENTION REGULATIONS l] and Fee Checked _ __ [Rev. I/07J (leave blank) �-- BY. A CATION FOR PERMIT TO PERFORM ELECTRICAL WO All work to be performed in accordance with the Massachusetts Electrical Code(1E C/S 12 U WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) �� City or Town of: YARMOUTH ' tpy this application the undersigned giiv s jotj o O UTH intention to peso to thhe 1Cce r o k described be ovation(Street&Number) I j i /L G , . ./C,,ilow, Owner or Tenant fre ria l Owner's Address Telephone No. Is this permit in conjunctlo ith a b i din permit? Yes ❑ No (Check A a Purpose of Building i' C Cr o n f J� Utility Authorization No. �T/ Existing Service Amps / r olts Overhead New Service �% Undgrd❑ No.of Meters !� • Amps bolts Overhead rg Undgrd Number of Feeders and Ampacity ❑ No.of Meters �_ Location and Nature of Proposed Electrical Work: i/v-e ni,,r Completion o the ollowin_ table m be waived by the In 'ector o Wires. .� No.of Recessed Luminaires No.of Cell:Snsp.(Paddle)Fans °•° ota ZNo.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA i No.of Luminaires Swimming Pool ,rode ❑ n- ❑ `o.o Units mergency g ng No.of Receptacle Outlets ' °d Bane Units No.of 0(1 Burners FIRE ALARMS No.of Zones - No.of Switches No.of Gas Burners `o.o I etec on an Ik.rInitiatin± Devices No.of Air Cond. ova Tons No.of Alerting Devices No.of Waste Disposers eat 'ump `uro er oas • " Totals: ......�...._......._........ o.o e Dote ne No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW un c a No.of Dryers Heating Appliances "cal Connection ❑ Other `o.o "a er KW `o.o .o KW ty ystems: Heaters o No.of Devices or Etuivalent S(_ns Ballasts Data Wiring: No.of Devices or No.Hydromassage Bathtubs No.of Motors a ecommunn ca•onsEl Total HP 'rnlent OTHER: No.of Devices or E•uivalent Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: (When 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 overage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND I certify,under the pains and penalties o ernu Othat the iTHER nformation on this application is true and FIRM NAM r•-• f p j ry� PP Licensee: l��r�j complete. ■fl.�/L�/t/�� LIC.NO.: (If applicable. nr 'axe I"fin II `• N/I / � � Address: - ,. LIC.NO.: L'� *Per M.G.L. c. 147,s.57-61,s•curity work requires Department l L= ' n 'ns•Tel. o. Alt.Tel.No.: �� OWNER'S INSURANCE WAIVER: I am aware that he Lice ,:ce does not have the liability insurance cover—`-- / ctyublic Sa "5"License: Lic. No. required by law. By my signature below, I hereby waive this requirement. I am the(check one Owner/Agent age normally Signature owner • owner's a:ent. Telephone No. PERMIT FEE:$ sv-