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Home My WebLink AboutBLDE-21-002352 Commonwealth of Official Use Only : Massachusetts Permit No. BLDE-21-002352 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:10/29/2020 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 30 PARTRIDGE VALLEY RD Owner or Tenant PARKER MEDEN J Telephone No. Owner's Address PARKER BRIDGETTE K, P 0 BOX 1233,SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appro A (j/ 23 Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 t j• t 0 Zi New Service Amps Volts Overhead 0 Undgrd 0 v et Number of Feeders and Ampacity O Location and Nature ure of Proposed Electrical Work: Replacement furnace. (#30) � � ' VVV Completion of the following table may be waived by t Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 1 Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 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 1 No.of Detection and Initiatine 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/Alertine 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 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: JOHN C BURKE Licensee: John C Burke Signature LIC.NO.: 50364 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:45 DIX ROAD EXT,WOBURN MA 018016104 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 ¶o (Ai(xL(L @ k- .6)k- .6) /41z917,1 W C, o, 4d 0/1/41466144Metta Official Use Only 1a1+ Permit No. --j,------ 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(MEC),5,27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 'J/?�;+ 0 City or Town of: '/A,i M a v 1 h To the Inspector'of Wires: By this application the undersigned gives notice of hjs or her intention to perform the electrical work described below. Location(Street&Number) 30 - / ,,2 J r I.dG 141 I I r--1 i 4 Owner or Tenant /40. .4..> l a,i j;,e.-,,-- J Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes a No ❑ (Check App 1 • at c- 1 ) Purpose of Building ✓+1 F/4,X. Utility Authorization No Existing Service Amps4 / Volts Overhead ❑ Undgrd❑ al N, of hers 0 New Service Amps I Volts Overhead❑ Undgrd ❑ . MAs ,✓ Number of Feeders and Ampacity C. -itLocation and Nature of Proposed Electrical Work: rt• r ,) r c Completion of the following table may be waived b , e I..sector, ires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Tr sf . TrTransformers A No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Pool Above In- No.of Emergency Lighting Swimmin g grad. ❑ grnd. ❑ Battery Units v No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones -No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Municip lonnection ❑ Other C 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 Egaivalent 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: O(i, (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 coverage is in force,and has exhibited proof of same to the ,-unit issuing office. CHECK ONE: INSURANCE J BOND 0 OTHER 0 (Specify:) L;eZ . I8I certify,under the pains and penalties of perjury,that the information on this applic,,, r rs ,ntplete, I FIRM NAME: .' ,� LIC.NO.: Licensee: 1 0 If rV 1( ci r K. Signature �� )J G i LIC.NO.: kf co 3C 41 (Ifapplicable,enter,`ex mpt in th licenscnumber line.) /.:K.,,\1 Bus.TeL No.: Address: 1-27._) L / X f CO1, w�K j + JA/ b S:,4Z V JJ1 f� J' �` Alt.Tel.No.: *Per M.G.L.c. 147,s. 57-61,security work requires Department of4 ublic 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 CO C --�� -� T l _L .. 1►T I PRRMTT PPP. IC /71