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Home My WebLink AboutBLDE-22-001694 w Commonwealth of Official Use Only s _ Massachusetts Permit No. BLDE-22-001694 _ ' 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:9/24/2021 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) 554 FOREST RD Owner or Tenant LEVITAN DOREEN N Telephone No. Owner's Address 554 FOREST 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: Exhaust fan &receptacle in bathroom. 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 Initiatine Device 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 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 Ballasts Data Wiring: Heaters Siens No.of Devices or Eouivalent 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: 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 Ga (� 1. 7( & C'u Uel bC9p) Commonwealth.a//aidachadetti Official Use Onlyly r,�°mF Permit No. -22— ` �P 9 Li 71� a a c�1.Jepartment o �ira�erviced Lii Occupancy and Fee Checked _ r y BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] o - „ (leave blank) i C �� w � A PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK O All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 W (4 a.,SE PRINT IN INK OR TYPE ALL INFORMATION) Date: September 21,2021 ILI J City or Town of: YARMOUTH To the Inspector of Wires: M i-Iget>fi application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 554 Forest Road Owner or Tenant Doreen Levitan Telephone No. 508-280-5430 Owner's Address 554 Forest Road, South Yarmouth, MA 02664 Is this permit in conjunction with a building permit? l'es ✓ No ❑ (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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Vent existing exhaust fan and install dedicated 20 amp circuit for GFI in bathroom Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil: P Sus . Tf Total(Paddle)Fans Tr Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1—No.of Zones of No.of Switches No.of Gas Burners No. Initiatinnggon Dete and In Devices Tot 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 HeatingKW Local❑ Municipal ❑ Other P Connection No.of Dryers Heating Appliances KW Security Systems:* rY No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications NofDeieor Wiring: y g No.of Devices Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 9/27/21 (When required by municipal policy.) Work to Start: $400 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 El (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 I PERMIT FEE: $ Signature Telephone No.