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Home My WebLink AboutBLDE-22-004413 Commonwealth of Official Use Only "i`` i Massachusetts Permit No. BLDE-22-004413 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:2/8/2022 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) 105 BEACON ST Owner or Tenant Joanne Sintiris Telephone No. Owner's Address 105 BEACON ST, 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: Remodel bathroom&laundry room. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 3 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 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 4 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ti 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 1 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 Total HP Telecommunications Wiring: 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: 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 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 q • U C-G741e,(7� . t FtNitiet ki11 (zz r 3� CEI - �- � VED. ._..� (,) fit Ca.(( 1 08 2022 S.7S--'[/fa 1 BUILDING r?-s"''-" T CominoruusaCth ofassctckuaals Official Use Only By -= r'� Permit No. G' -I{�(.3 _=_ s+!= Jicparlmcnt o{.7ire&rvlua t_— • Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) AL7D1 1!'/►Ttnit rne� r,�.....� _ - . .= :;-: • � :.; i � C.i PEFrvtuvl tLtG RICAL 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: .. / , City or Town of: YARMOUTH To the I_pector'o Wires.• By this application the widersigned gives notice of his or her intention to perform the electrical o k described below. • Location (Street&Number) /f / $ ,5/f[9-C`cam,l/ R c/ Owner or Tenant J re,„t/71_,;e_ 5-i. "� /1;'-t S I Telephone No. ;'/ Owner's Address , 5 `— ,z,t TTS )Z cf 15( � 7 - ,�r�i�✓} ,fr'l. fy7y 5' C' _ >../.,,,,---,7 Is this permit in conjunction with a building permit? Yes V No ❑ (Check Appropriate Box) Purpose of Building /aF cit"77,` /r, , / Utility Authorization No. Existing Service Amps �� / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead E Und rd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the following table may be waived by the Inspector of Wires. - No.of Recessed Luminaires '3 INo.of CeiL-Susp.(Paddle)Fans No.of Total Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of LuminairesSwimming pool Above ❑ In- No.of Emergency Lighting erad. srnd. Battery Units No.of Receptacle Outlets J No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches J-1 No.of Gas Burners • No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tan No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal _ Connection ❑ � No.of Dryers / Heating Appliances KW Security Systems:« No.of Water Na of No.of Devices or Equivalent Heaters KWNo.of Data Wiring: Sighs Ballasts Na.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: c c 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: 6 c /'.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C PAGE: 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 tiz BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAIL:- LIC.NO.: Licensee: ., . - iA Signature Jct_J 4S'?.../-,-/-e �_ (If applicab e, en -r "erem_pt"in the license number line.) ` LIC.NO.; J S"U 4-•/ Address: .i r4 ;G Cr .✓� '. _` Bus.Tel.No.: D Alt.Tel.No.: �j` c1 j *Per M.G.L. c. 147,s.57-61,security work requires Department . Public Safety"S"License: Lic. No. ,,,,z— OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage�normally S required by law. By my signature below,I hereby waive this requirement I am the(check one 0 ownero Owner/Agent 0 owner's a eat Signature Telephone No. PERMIT FEE: $ 7s-.-