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Home My WebLink AboutBlde-21-005889 or Commonwealth of Official Use Only Iiiii— ,§ ' Massachusetts Permit No. BLDE-21-005889 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:4/13/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of has or her intention to perform the electrical work described below. r] Location(Street&Number) 17 PEREGRINE LN toll l 'a_ 8 Fe Owner or Tenant BURKE CHRISTOPHER J Telephone No. ` Owner's Address BURKE JUDITH M, 14 KIMBALL AVE,WAKEFIELD, MA 01880 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Receptacle for fire place blower. 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 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 Data Wiring: Heaters Signs Ballasts 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: A J Pulley Licensee: A J Pulley Signature LIC.NO.: 21843 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:289 QUAKER MEETING HOUSE,RD,E SANDWICH MA 025371366 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 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 ' Commonwaik o`Mamaducistia /Official Use Only - _f1 Permit No. E2 6O 9 • 'r"_ artier Serviced , __I_(_ Occupancy and Fee Checked :4 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 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: e-i-Q-Z t d City or Town of: i.i-O-KA,hirit To the Inspector of Wires: By this application the undersigned givnotice of his or her intention to perform the electrical work described below. Location(Street&Number) ,7 1 -VLEC5c2,N, L,M. S- 10417, Owner or Tenant C4.},E15 go*LIEF Telephone No. ;, Owner's Address � \ Is this permit in conjunction with a building permit? Yes El No � (Check Appropriate Box) �,1� Purpose of Building lc,S . 1AL Dk,�,E,r,,,,p, Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (,v s,r4t, izetEpr-A0 E , 4s(I?.A- F 42,2. !�.45 i"No cEALs hr�rI E -o••.t.n_r As ,.) 'St ,i----. -- -"'""""` Completion of e followingtable may be waived by the Inspector of Wires. '(`. u. . '- No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA ., _ - No.iof Luminaire Outlets No.of Hot Tubs Generators KVA -' _ Noe of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units Ilug '-No of Receptacle Outlets 0 No.of Oil Burners FIRE ALARMS No.of Zones Rio,of Switches No.of Gas Burners-.: , No.of Detection and �,_' ; Initiating Devices -. Total Ci`,. ------w---Flo of Ranges No.of Air Cond. Tons No.of Alerting Devices - r No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices v No.of Dishwashers Space/Area Heating KW Local❑ Choln ❑ Other ¢ No.of Dryers Heating Appliances KW ‘'Security o y onnecf Devices or Equivalent 4 No.of Water No.of No.of Data Wiring: V' Heaters KW Signs Ballasts No.of Devices or Equivalent Q Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent v ki OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. L► Estimated Value of Electrical Work: (When required by municipal policy.) r a Work to Start: `j -Zl 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [`r3OND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: t..).4ii Cat ,64g i Fuspruc_ LIC.NO.: Licensee: 43 fp ,,y Signature LIC.NO.: 4z,PYI/3 (If applicable,ewer"exempt"in th icense number line.) Bus.Tel.No.:S)r 32>/3 V3 1 Address: //() /AI /90/ 5c14.'rt /)c-AtAitt, it t4 D24.4 i) Alt.Tel.No.: *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. PERMIT FEE: $