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Home My WebLink AboutBLDE-22-002327 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-002327 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:10/22/2021 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) 10 PERCH POND WAY Owner or Tenant SMITH JEFFREY S Telephone No. Owner's Address PO BOX 214, YARMOUTH PORT, MA 02675-0214 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 ❑ 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: Wiring for detached building w/underground. 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 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 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 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: Paul M Ryder Licensee: Paul M Ryder Signature LIC.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: $150.00 'en-tit* r . Vf A'?4)(- t ( Z7i� rJ Commonwankh e/Maddachueaffa Official Use Only �7 \ c.,:i ry, �7Permit No. ZZ 'Z�Z/l\ 2 parimeni ei.Jiro Serviced BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.1/07] (leave 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: A/Z Z/Z/ City or Town of: YARMOUTH To the Ins ctor of Tres: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) /a <."-� 4 . /r//_4.e/ Owner or Tenant T-Pry"(y f/17 t� V Telephone No.ad 4 U,Z7 N! Owner's Address ,r4qu 1 Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) of Building 1.f L /1/ G.YUt 7 Utility Authorization No. Existing Service Am / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity .re Location and Nature off Proposed Electrical Work:�t,_,, �" e_/T'' �/ } / W_ , .ii l am).-f �" . 1/.U'vr./tporpose nc T-..� /L-.ei "Yfr 4- 77 .1..i4L J P. ue Completion of the following table miry be waived by the l0000ctor of[Mires. / ls?. No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Total Transformers KVA (C No.of Luminaire Outlets No.of Hot Tubs Generators KVA -4!' No.of Luminaires Swimming Pool Above ❑ in- No.01 Emergency Lighting brad. g_t'nd. ❑ Battery Units . `r No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS]No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices Tota i 1? No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste DisposersHeat Pump I Number[Ions 1KW No.of Self-Contained Totals: -` '"` -` Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑Municipa Connection D OMer No.of Dryers Heating Appliances KW Security Systems:* ' No.of No.of Water Beaten KW No.of No.of Data Wiring: or Equivalent Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No,of Motors Total HP 'telecommunications Wiring: No.of Devices or Equivalent OTHER: 0•s Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work. r0 0 0 (When required by municipal policy.) Work to Start:w iu L/ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C EIYAGE: 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 the ains and penalties of perjury,that the information on this application is true and complete. FIRM NAME:�/C- E�r�r.-L J j)fy/ lie, LIC.NO.. �j / Licensee: 4-v I t4 the Signature /t _, LIC.NO. / 7 b`C (If applicable, ter"ezesnp in the license numberline.) Bus.TeI.No.• / ) Address: P I 6.is- 1/1 a 0,/ i/(s /14. Alt.Tel.No.:vi ��j 1 Per M.G.L c.147,s.57-61,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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$