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Home My WebLink AboutBLDE-23-002560 Commonwealth of Official Use Only E`. 4) Massachusetts Permit No. BLDE-23-002560 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:11/8/2022 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) 58 HOLLY LN Owner or Tenant LEEDS SHEILA G Telephone No. Owner's Address PO BOX 446, 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: Install 20 amp circuit to bathroom&swap out fan. 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 1 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 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 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 ❑ 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 LTC.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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 REE►VED NOV 08 2022 BUILDING - ryy� „yw ay: I rt/aeeac�iaealfe Official Use Only ''1'6O•" cc77 & Permit No s :-•mow e . ire pekoe Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.I/07) (lave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK v 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: P/, —"ZZ City or Town of: YARMOUTH To the IN ector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) ,c7/ /( // / Owner or Tenant Si-,E.�/ri / j / CDs Telephone t,®g)3Ra— 6og Owner's Address S 4 la this permit in conjunction with to building permit? yp No.pp77 ❑ .ram (Check Appropriate Box) Purpose of Building/( C u Utility Authorization No. J Existing Service j/—r Amps / Volts Overhead ❑ Undgrd E No.of Meters _ ' . New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Beaton and Nature of Proposed Electrical Work:Ald 12411, Cample n of thefollo4ingtable mT,be waived by the Inspector of Wires. lb No.of Recessed Luminaires No.of Cell:Sasp.(Paddle)Fans No.or total Transformer KVA n No.of Luminair Outlets No.of Hot Tubs Generators KVA d' No.of Luminaires Swimming Pool Above In- No.of Emergency Lighting trod. grnd. Battery Units :::,' No.of Receptacle Outlets No.of OB Burners FIRE ALARMS INo.of Zones No,of Switches No.of Gas Burners No.of Detection and 1�� Initiating Devices No.of Ranges No.of Air Cotd. i otal Tons No.of Alerting Devices No.of Waste Disposers -Neat Pump Number„Tons -KW No.of Self-Contained Totals: - Detection/Alerting Devices No.of Dishwasher Space/Area Heating KW Local❑Musicil a 1-1 Connection Other No.of Dryers Heating Appliances KW "'Security Systems:. KNo.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent py Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: /)O (When required by municipal lie Work to Stan: Lv F�policy.) // 2 Z to be requested in accordance with MEC Rule I0,and upon completion. INSURANCE COVE GE: 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 d-BOND 0 OTHER 0 (Specify:) I sertlfy,under the pa and penalties of perjury,that the information on this application is true and complete.FIRM NAME: T/"/`�/ �L Y jJC•� / .��/y�/7�C/, I'- t C r/cc ,"( L C c LIC.NO.:_=f, t '.. t Licensee: /R-/ p,i Oe✓C Signature Zt .... LIC.NO.: (If applicable.enter'pow"In the license number Used Address: f/4 A'x- (/L( �)fle'-ve./� Alt.But.Tel.No.: 1 —‘�j3/ Per M.G.L.c.14,s.57 I,security work requires Department of Public Safety"S"License: Lic 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ l