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Home My WebLink AboutBLDE-23-003082 .... Commonwealth of Official Use Only i '11. --- - Massachusetts Permit No. BLDE-23-003082 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:12/6/2022 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) 674 ROUTE 28 n Owner or Tenant WHYDAH MUSEUM Telephone No. �I Owner's Address 674 ROUTE 28,WEST YARMOUTH, MA 02673 Oit't S,'i , Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) ,` t�,11�Purpose of Building Utility Authorization No. 10258178 Y- Existing Service Amps Volts Overhead 0 Undgrd El No.of Meters 100 New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Restore service to green house building. 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: Jeffrey W Spiegel Licensee: Jeffrey W Spiegel Signature LIC.NO.: 15883 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:50 GINGERPLUM LN, EASTHAM MA 026422616 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: $80.00 /i4 e f4 l , (x ) „bin. (t- Oi,Y _* Commonwealth el'"'�d"ch"dB Official Use Only ^`�1== 2e a,tment o Pcedermit No. ' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked APPLICATION FOR PERMIT T® [Rev. 1/07] ------ (leave blank) All work to be performed in accordance with the Massachhusett PERFORM ELECTRICAL WORK (PLEASE PRINT IN INK OR TYPrE TI (MEC),527.CM812.o0 or Town of: ��' h" l Date: Z — 7-- City �' f Wires: By this application the undersigned ) To the gives notice of his ore intention to pe orm the electrical w k desc bed belo Location(Street&Number) Owner or Tenant l D 7I t Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes NO (Check Appropriate Box) Purpose of Building Existing Service f t, , Utility Authorization No. 1 �x 6/ 7 Amps / L Volts New Service p ---�=y` Overhead❑ Undgrd No.of Meters �_ Number of Feeders and Ampacity Amps / Volts Overhead F. Undgrd No.of Meters _ Location and Nature of Proposed Electrical Work: Completion of the followin. table may be waived br the Ins,ector of Wires. No.of Recessed Luminaires No.of Ceil._Susp,(Paddle)Fans No.o otal No.of Euminaire Outlets Transformers KVA No.of Hot Tubs No.of LuminairesGenerators KVA Swimming Pool n Above ❑ In `o.o mergency Ig,trng No.of Receptacle Outlets _rnd. ❑ Batter Units No.of Oil Burners — _ No.of Switches FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and II No.of Ranges Total Initiating Devices No.of Air Cond. No.of Alerting Devices No.of Waste Disposers Tons :eat ump Number Tons i o.of Self- ontained Totals: No.of Dishwashers ;Detection/Alertin. Devices Space/Area Heating KW Local❑ Municipal No.of Dryers HeatingA Connection ❑ Other Appliances O.0 Dater KW ecNo.o stetns:x Heaters KW No.of No.of No.of Devices or E 1 uivalent Sins Ballasts Data Wiring: No. Hydromassage Bathtubs No.of Devices or E I uivalent No.of Motors Total HP Telecommunications 'firing: OTHER: No.of Devices or E e uivalent Attach additional detail if desired, 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 the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. undersigned certifies that such c�rvage is in force,and has exhibited proof of same to the permit issuing office. issue unless CHECK ONE: INSURANCEq The .0 BOND ❑ OTHER ❑ (Specify:)j certify, under the pailsand penalties o p �'�) FIRM NAME: %i of inforntatioti qn this application is true and complete. Licensee:,t/ j s f i , f 1` (— LIC.NO.: t. i, Signature i .,� ; 1 „_,,(If applicable,en "ez pt in the'license number line.) �' �' LIC.NO.:%�?' �l '7 Address: �� .—, `. r —'i , _1 ar l-').%,!4 / 'i °`I- f a� ;a_!,f,f �- ='J ,. Bus.Tel.No.: '''r_f Per M.G.L. c. 147,s.57-6lsecurit�work requires Department of Public Safety`S` License: fit'Tel.No.: — i -� OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally Lic.No. ; ! _ ' required by law. By my signature below,I hereby waive this requirement. I am the(check one) Signature ❑owner ❑owner's ag mt. Telephone No- PERMIT��,E. �/ l