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Home My WebLink AboutBLDE-22-005079 Commonwealth of Official Use Only E. ,I " Massachusetts Permit No. BLDE-22-005079 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:3/14/2022 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) 250 SOUTH SHORE DR Owner or Tenant Justin Eckelman Telephon• o. .0 Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 ( ..* rtQi"rt@c*$ox) Purpose of Building Utility Authorization No. �C-. -,,` .: :r,'j Existing Service Amps Volts Overhead 0 Undgrd 0 $. t'M`etecs "\, New Service Amps Volts Overhead 0 Undgrd 0 Wo.bfMMterd Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement furnace. <„ - Completion of the following table b hivcd i 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 ! C KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 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/Alertine 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 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: Shawn A Souza Licensee: Shawn A Souza Signature LIC.NO.: 39768 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:31 LAKE DR, PLYMOUTH MA 023605648 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 "3 W(I( CCt (( AReCEIVED CMAR 14 yy / Ca am.nw.ateh . -_4„yC, a�rt/aServi Serviced Official use Only Y'... : ccyy, cc77 Permit No. ��7 1 7 Q BUILDING U�. _alp:... .CJtloartmanl of J' J J.L.L/t��.7 / I By— -- -I1-j rn aNICId BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07) (ms„blank) 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: City or Town of: YARMOUTH To the Inspectorf By this application the undersigned gives notice of his or her intentio to to �0�the electrical O Wjescr Location(Street&Number) cj ptj bribed below. Owner or Tenant 5 'rl ...c.IG.e 1 VnCI., Owner's Address Telephone No I Is this permit In conjunction with a tiding rmit? yes Purpose of Building 5 U�tY yo (Check Approp to Box) kothe I Existing Service rizetlon No. Amps .tt Volts Overhead Undgrd New Service g ❑ No.of Meters _ Amps / Volts Overhead❑ Undgrd Number of Feeders and Ampacity g ❑ No.of Meters _ f Location and Nature of Proposed Electrical Work: Lt.),/Ls„� • _ �171 c,C�.JhC G r`✓I 'j—y ... cry �t- t Lb Com!Mon o the ollowin table m be waived b the Ins woe o Wines, No.of Recessed Luminaires No.of Cell:S°pe.(Paddle)Fans °•o ota " No.of Lumina Hot re Outlets Transformers KVA No.of Tubs Generators KVA d` No.of Luminaires Swimming Pool rode ❑ n ❑ o.o mergency g ng No.of Receptacle Outletsnd• Bette Units No.of Oil Burners FIRE ALARMS No of Zones No.of Switches No.of Gas Burners o o etec on and I`' No.of Range initiatin Devices No.of Alr Cond. ota Tons No.of Alerting Devices No.of Waste Disposers 'eat'ump 'um u er •" Totals: ................. mom __. 'ete o. e on in, No.of DishwashersDetection/Alert{n Devices __ Space/Area Heating KW Local❑ •un c pa No.of Dryers Heating A Connection ❑ �. g Appliances ecu ty stems o.o a er No.of Devices or E ufvelent Heaters KW °'o a. SI ns Ballasts Da[a Wiring: Na.Hydromassage Bathrobe No.of Devices or E ufvelent No.of Motors Total HP c ecommun ca ors r ngg: OTHER: No.of Devices or E ulvaleot Estimated Value of Elec al Work' Attach addirequired detail i_desired dry required by the Inspector of Wires. -t,_• (When required by municipal policy.) Work to Stan:'3 /, 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 insu ncluding'•compieted operation"coverage or its substantial equivalent. The undersigned certifies that such cover in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE B[ BON 0 OTHER true and complete. I certify,under the alns and ❑ (Specify:) penalties ojpeyury,that the in ormatlon ore th a hcation is ae FIRM NAME. l �� PP• Licensee:y5"`0.Kn) Si ■' C.NO.: IT 76 j� (Ifopplicabl en: "er IC.NO.: 3 7 Address: nip"in tic e t berCe.) 'Per M.G.L.c.147,s.57-61,security Y•['r7 Boa.Tel.No.. — —f/6 7? ty work requires Dep ens of Public SafetyS•'License:Alt.TeL No.: Lie.No.OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not hove the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one Owner/Agent �• owner Signature owner's a•ant. Telephone No. - . t • • ••••-_