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BLDE-23-003904 expired
Commonwealth of 0Official Use Only Massachusetts Permit No. BLDE-23-003904 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:1/18/2023 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) 822 ROUTE 28 Owner or Tenant WISE LIVING RETIREMENT Telephone No. Owner's Address 822 ROUTE 28, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes ❑ 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: Minor repairs/corrections within commercial areas 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 Tot No.of Ranges No.of Air Cond. Tonal 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: 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: $160.00 Nrit t( Ztq 23 tee (9:07)Atei) C-._ 1-pr* ImTA.. [-_ Tpu .Ems /4/0/5- -f . Di • AA,, /iyy�] // 1 -. • nwea o amachamdlaOfficial Use Only [jAN _ C.2� 34O'-t • .Y;'�.; �'7 [� Permit No, .-:�:.,. eearlmenl o`Jiee Jeevicee BUILDING DEkk--. li—j Occupancy and Fee Checked ii By._ --e.,�.',.,r BOARD OF FIRE PREVENTION REGULATIONS kRev,1/071 (leave blank) APPLICAll work to be ATION pFOR PERMIT erformed in acconiance TO PER the FOEleRM E RIC9(L WORK /� 2 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: % O City or Town of: !!! / YARMOUTH To the pe ararfr es: . By this application the undersigned gi �otipe of • her'"on to perform the elect ia.1 work gibed below. Location(Street&Number) �� q}tL(LI Owner or Tenant 114 6-e L14 p, %re e��� Telephone No. Owner's Address / Is this permit In conjunction with a building permit? yes ❑ No (Check Appropriate Box) Purpose of Building Utilityuthoriratian No. _ Existing Service Amps / Volts Overhead❑ Undgrd rvlce Amps B ❑ No.of Meters _— P / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty Location and Natule of I7oposed Elecirical Work: Camp elton of the following/able may be waived b the/n cr o Wires. W No.of Recessed Lamivaires No.of Ced.-Susp.(Paddle)Fans No.of y toro- No.of Luminaire Outlets Transformer KVA No,of Hot Tubs Generators KVA d' No.of Luminaires Above In- No.of Ismergency Lighting Swimming Pool grad. ❑ grnd. ❑ Battery Units , No.of Receptacle Outlets No.of OR Burners FIRE ALARMS INo.of Zones No.of SwitchesNo.of Gas BurnersNo.of Detection and i" No.of Ranges �— Initiating Devices No.of Alr Cond. I eta/ No.of Alerting Devices Tons Heat Pump Number.Tons 1KW No.of Self-Contained No.of Waste Disposers Detection/Alerting Devices N.of Dishwashers Space/Area Heating KW Local❑Municipal No.of Dryers Connection ❑"'"er rY Heating Appliances KW Security Systems:* No.of Water , oR'u'—'r— Na.of No.of Devices or Equivalent Heater Signs Ballasts Data Wiring: No.Apdromaase a Bathtubs No.of Devices or Equivalent B No.of Motors Total HP Telecommunications Wiring: - OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspect of Wires Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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 eovrage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND El OTHER❑ (Specify:) rtify,I ce under the pains and ;sallies of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: �' LIC.NO.: Of applicable the Itne'/ Signature / (. LIC.NO.: I Ll Fi' Address: . •,Pi /,• de /j •to/ o ' giI 7c5 Bus.Tel.No.`/ ti?Zl L^'� yU 2j' •Per M.G.L.c.147,s.S/ s ity wontrequires VDep K t of Pubti Sa ety"S'''`L ee se: Alt Lie'No No.`T'7�-�"e--�^t/J (/ OWNER'S INSURANCE WAIVER: I am aware that a 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/Agent owner's aeent Signature Telephone No. PERMIT FEE:$ s2 7 _ - . • I r BUILDING W�"v I J F �; I 1.I�C;TI:ICAI, q �,� GAS O 4' G SETTS 0 6�4 4 5 PLUMBING 1 ; 1146 ROUTE 28 SOUTH YARMOUTH MASSACHU. . tr •. A) x - (508) 398-2231 , Ext. 261 Fax (508) 398-083 SIGNS Telephone MATTACH z. SE �0� Arn '' ��,,�`' BUILDING DEPARTMENT .,.;::�:.; VIOLATIONNOTICE OF Inspection � Date: t2 q �i Inspection Type: (45ane-leni... Property Addres s: gi2 Braze i 5c % r4,'. 61t, / My Owner !� Tenant I. Name: Loot:-��- L--+ �) w • Telephone:D / B / A: _ • Mailing Address: State: Zip Coe City / Town: . bythe undersigned, during which the captioned property was conducted An inspection of the above p 1- Poll owing VIOLATIONS were observed: r I - ', I it ,iliAN' .1 ' 4!'• 17 Tli._9 Ps ...:- . -- r ii i 1 ..:; -I Ai ir i.-- t - , ? r; P dr, 44 .) -'7*-,____LLLCZ___—. _____ l ew N .,�' �. 12 . --'r,'.,I. ,,. C fir"" I'i�""'i!'�"�"� � 'E'er - i •M �_.L- ✓ ° ' A P Kr" •' - _ ! w fil�• ' KEIA.A4. • ���41' �"'F'/��_____ IF-4 — — Nii sr' , , 4 1% li 4 i CE ll ,,I____i j a 1 i i i E:-.- ' 1 " i C 1 * AA rg 14.04411-0.4 'Z " 'ir Sv.t 1 ,11. / 7 f . 0 Ar .14 _ _ a _ 1 )k -1 .,, L S tir gat r 5,4 4 ite -I. ' 0 T r t As --8341•6.4 rt) ." Ay; violations within days . ',.� re hereby ordered to abate or correct said �� • - Ou, which may be subject -: �, ,• in criminal/civil complaints being filed against y Failure to "' ' result may the issuance of your license. prescribed pertinent laws and regulations, or delay to fivesiws You . for a re-inspection by the time noted ralsor. ire toe • { tact the Building Department ( //1 ,. , ' Sigrge& i 43 P , (5r ..1 ,...i_ mattzreit iz./91442- Taft " ! , Y f ,0•00'' +y, �� _ T Authority Parr �'►ld� Det)I. ���ii '"� :;I�,�! .�iv'�it'iri�,y" �,,.�y';!p� :`�r, L.wNu..��?,�'- . 1.,;, 4 • ki,LailWagliallaMilaradnagtantiMaitr4VrItrall,YAVO'a 19Md•1`.�' '.' I'lSa i�jR� N I. Jl • - , . . • . , . . • ; . '..-;i1 ,II`.;7• - ''I II-'-,;•••••-•-:I.-•-''.-'••I:" • '-1'' „ ,.• 00/•••----""*-•4, i i .' ' ,47"7"' ,e... t. ...>' ''',,',', ' . 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