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Home My WebLink AboutBLDE-22-006157 Commonwealth of Official Use Only to Massachusetts Permit No. BLDE-22-006157 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:4/26/2022 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) 1 FILLMORE RD Owner or Tenant JACKLES FRANCES M Telephone No. Owner's Address 1 FILLMORE ROAD,WEST YARMOUTH, MA 02673 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: Septic pump&alarm. 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 grad. 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. Tootal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained 1 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 Eauivalent No.Hydromassage Bathtubs No.of Motors 1 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: THOMAS E CUNNINGHAM Licensee: Thomas E Cunningham Signature LIC.NO.: 8410 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO Box 48, Leicester MA 015240048 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:$75.00 RECEIVED flooR 25 2022 11 BUILDING DENARNT ey. Commonwealth.o Maadachueatie �-�O-fficial Use/ Only — i-.....,..t.,,„,„.., , F �[ imanf o`-} S' Permit No. rJ/��P(✓ /7 spar ira arviced ,a;l l ?� Occupancy and Fee Checked �' , 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(M ),527 R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: a-71 S y City or Town of: YARMOUTH To the Inspector o Wires: By this application the undersigned give otice of hi orelaer intention to perform the electrical work described below. Location(Street&Number ' LIM 0 1Z47/ Owner or Tenant w NI Telephone No. Owner's Address c/4174'4 . i Is this permit in conjunc on with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building CI De i//7 di_ ii/ Utility Authorization No. Existing Service Amps / Volts Overhead El Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: W/Pe-/VCU 5 /j7t' I2U,,-t,/ VI Completion of the following table m be waived by the Invector of Wires. '‘tu she U. No.of Recessed Luminaires No.of Cell.-Susp. No.of 'Total U. (Paddle)-FFans Transformers KVA �t No.of Luminaire Outlets No.of Hot Tubs- Generators" KVA r_, Wit' No.of Luminaires Swimming pool Above ❑ In- No.,or1�mergency Lighting - grad. grnd. ❑ Battery Units �' No.of Receptacle Outlets No.of Oil Burners R FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners - 'No.of Detection and • Initiating Devices t:` No.of Ranges No.of Air Cord., ' r Total Tons No.of Alerting Devices No.of Waste Disposers..'' Heat Pump .1�(umber Tons KW No.of elf-Contained Totals:I"" "' "'"""} Detection/Alerting Devices No.of Dishwashers' Space/Area Heating KW Local❑ Municipa Connection 1--1 other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heater ' No.of Data Wiring: 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 E ctnc Work: APD (When required by municipal policy.) Work to Start: 5" , Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO ERAGE: 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 aims and penalti s of perju ,th t t_i information on this . .'lication is true and complete. FIRM NAME: GI/IfG��yfj /( Lit"G1/Cnt.. • Licensee: /l 4'L.'I /N LIC.NO.: ey-a Signature •r.c.rf. LIC.NO.: .-1',:.;.,- or 91.5"/ (lfapplicable,ente emp ' ' t e lir.eyse npinber!ie.) Address: G'"�f ' ( /'(/1t' D&I' .. Bus.Tel.No.• ``%.` �, Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt 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/Agent owner ■ owner's a:ent. Signature Telephone No. PERMIT FEE: $ s.nv