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Home My WebLink AboutBLDE-22-002711 ,t Commonwealth of Official Use Only it Massachusetts Permit No. BLDE-22-002711 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:11/10/2021 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) 11 MEADOWBROOK RD Owner or Tenant PETRILLO MICHAEL J TRS Telephone No. Owner's Address DUNHAM CHRISTINA M TRS,440 EAST ST, MANSFIELD, MA 02048 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade 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 No.of Luminaires Swimming Pool Above ❑ 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 No.of Detection and Initiating 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ 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 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: JOSHUA B DEJOIE Licensee: Joshua B Dejoie Signature LIC.NO.: 53490 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 10 LEXINGTON LN,YARMOUTH PORT MA 026752437 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 c ex at, 6(.7e, a...A R CEIVED [1.0V. C8 200221 Commonwealth oil7addachadette Official Use Only BUILDINGD,p : ilk, T I—/�7� Z7( ( a�1, c� �. s Permit No. `/ t� —2, t ,MN 410 .1Js/vartmsnt of. ire Serviced -11 Occupancy and Fee Checked i BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) ' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 11 All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 CJ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1 i-5 - City or Town of: YARMOUTH To the Inspector of Wires: 'v By this application the undersigned gives notice of his or her intention perform the electrical work described below. Location(Street&Number) 11 e c X ci�, ( r`C Owner or Tenant ri\,\(.C. Z-\-c t, Telephone No. q/ Owner's Address I '\e"in,; 'cu.;1k ?A d Is this permit in conjunction with a buildingpermit? Yes'o� p ❑ No Gcl (Check Appropriate Box) Purpose of Building 0 U'.‘1 . Utility Authorization No. Existing Service ibt Amps Volts Overhead ❑ Undgrd ri No.of Meters New Service a00 Amps / Volts Overhead❑ Undgrd ❑ No.of Meters �' Number of Feeders and Ampacity ' () Location and Nature of Proposed Electrical Work: 7C C<<cl`�? zx ,C� '-k,„ �on,p,.rlf •„i Completion oo the followingtable may be waived by the Inspector of Wires. Total i No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of- KVA o Transformers KVA '-;t No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting _rnd. and. 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. Tons) No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons 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 Devices or Equivalent _ No.of Water Heaters KW No.of 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 Electrical Work: ,OC.0 (When required by municipal policy.) Work to Start: (1 •.b-),\ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permmit 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 EJ BOND 0 OTHER ❑ (Specify:) I certify,under the alns and penalties of perjury,that the information on this application is true and complete. FIRM NAME: itc.AA C c, e. .,‘, t`CLA 6 L i c.'y\ LIC.NO.: Licensee: -cS1\v D 61,C Signature LIC.NO.: m cv_.3 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.' Address: Alt.Tel.No.: 774 `(` i- 01-1P,3 *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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ 6 D--f C 416