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Home My WebLink AboutBLDE-22-004284 Commonwealth of Official Use Only IL thi Massachusetts Permit No. BLDE-22-004284 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:2/2/2022 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) 12 BURCH RD Owner or Tenant Thomas Fitzpatrick Telephone No. Owner's Address 12 BURCH RD, SOUTH YARMOUTH, MA 02664 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 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Temporary service. 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 s j No.of Luminaires Swimming Pool ove ❑ In- o No.of Emergency Lighting Abgrnd. grnd. Battery Units 11 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and 10%1) Initiatine 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 i No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: l Heaters Stuns No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: (...--,j No.of Devices or Eauivalent 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: REILLY ELECTRICAL CONTRACTORS Licensee: Sean Reilly Signature LIC.NO.: 22960 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 14 Norfolk Avenue, Eastson MA 02375 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: $50.00 NZ , (Mit 20.0C-a-rs» RUM , b zanEAuP all e-,e) 2��-1 Z ACommonweal o/74uachuoetta Official Use Only 1 - cc��rrc7 Permit No. e....22-1+242_,L1 `-,it-=_j = 2epartment°` fire ervice. Occupancy and Fee Checked -�,' �:= 7 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] ill N (leave blank) iF— I �`' N 0 " PLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK I All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 W wLU YARMOUTH To the I(I SE PRINT IN INK OR INFORMATION) Date: February 1,2022 , ires: ,,i o City or Town of: P of Byl Ii pplication the undersigned gives notice of his or her intention to perform the electrical work described below. Ct Lodi (Street(Street&Number) 12 Burch Road Owner or Tenant Fitzpatrick,Thomas&Allison Telephone No. 508-237-9812 Owner's Address 12 Orchard Blossom Road, Windham, NH 03087 Is this permit in conjunction with a building permit? Yes V No ri (Check Appropriate Box) Purpose of Building Residential Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd n No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of a 100 amp temporary service Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle Tf Total)Fans Tr Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool grnd. Above In- No.of Emergency Lighting ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of No.of Switches No.of Gas Burners No. Initiatinnggon Deteand InDevices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained P Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑No.of MunicAle ❑ Other No.of DryersHeating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsN . fDeiceor Equivalent No.of Devices Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: $1000 (When required by municipal policy.) Work to Start:2/1/2022 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 ® BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information n this plication is true and complete FIRM NAME: Reilly Electrical Contractors, Inc. LIC.NO.: 556 Al Licensee: Sean Michael Reilly Signature LIC.NO.: 22960-A (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:508-394-3211 Address: 14 Norfolk Avenue,Easton,MA 02375 Alt.Tel.No.•508-400-8936 *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: $