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Home My WebLink AboutBLDE-22-003767 o - =%-` Commonwealth of official Use Only A� '► Massachusetts Permit No. BLDE-22-003767 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:1/6/2022 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) 10 MACKENZIE RD Owner or Tenant BAKER THOMAS C Telephone No. Owner's Address BAKER LISA, 53 BIRCH HILL RD,WEST BROOKFIELD, MA 01585 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 gNo.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: Service upgrade 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 INo.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 I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Municipal Local 0 P 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent 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 I certify, (Specify:) fy,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(If applicable,enter"exempt"in the license number line.) Tel. NO.: 53490 Address: 10 LEXINGTON LN,YARMOUTH PORT MA 026752437 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 II Zl 7 PcEsfr - a. (T'cb, 5p ./C` ``t c L J6 .to LI t q( A-{ 0.--t'Z,v 6112 A g5-I fry--- 1 JAN 06 2022 BUILDING v r_N `- ' ►7 Commonwealth oi///aedachiwe(te Official Use Only Permit No. t 22---37 CD1epartmsnf o`}rrs Serviced §- i`(; J BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [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),527 CMR 12.00 Q (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 4 r C City or Town of: YARMOUTH To the Inspector of Wires: s By this application the undersigned gives notice of his or her rote lion to erform the electrical work described below. `' Location(Street&Number) 1 b I Gt 1 4-- Owner or Tenant kV u l Owner's Address Telephone No. '77 y OC Ll a.�C`D (l� �citkt Z.t Is this permit in conjunction with a building permit? Yes [❑ No [Z1 r6 t Purpose of Building ,i-\ (Check Appropriate Box) ` Utility Authorization No. t ...)1 Existing Service Amps / Volts Overhead ❑ Undgrd 0 No.of Meters /1) j New Service Amps / Volts Overhead oNumber of Feeders and Ampadty ❑ Undgrd 0 No.of Meters Location and Nature of Proposed Electrical Work: n 5 A- ` ,o, BLt Wkec'-t. e GS �t+J bOft �ec� tc t?> i t.j(Inye tr ...4'n 0 Com tetron o the ollowin table m be waived b the In ctor o Wires. tl) No.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fans °•o ota .t No.of Luminaire Outlets Transformers KVq � No.of Hot Tubs Generators KVA ,6 4 No.of Luminaires Swimming Pool rode ❑ °- B at o.te Unitsmergency g ng nd. ❑ 0 No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS No.of Zones 1v, -- No.of Switches No.of Gas Burners o.o etec on an Lr t No.of Ranges Initiatin Devices No.of Mr Cond. ota Tons No.of Alerting Devices No.of Waste Disposers eat ump um er ons Totals: o.o e - oats n No.of Dishwashers Detection/Alertin Devices '� Space/Area Heating KW Local 0 un a ti • a`)i No.of Dryers Heating Appliances KW ecu ty Cystemson ❑ �� C — o.o a er ° o No.of Devices or Equivalent v' Heaters o.o G Si ns Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Devices or E uivalent g No.of Motors Total HP e ecommun ca ons g OTHER: No.of Devices or E uivalent oi Estimated Value of Electrical Work: yQ Attach additional detail if desired,or as required by the Inspector of Wires, S Work to Start: (When Tequired by municipal policy.) v 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. 3 CHECK ONE: INSURANCE 1 BOND 0 OTHER C I certify,under the pains and ens es of perf uryt that the information on this application is true and complete. FIRM NAME: h S c_. V t E f.t_TC t CI t:.'(\ Licensee: LIC.NO.: (If applicable,enter"exempt"in the license number line.) Signature LIC.NO.: Address: � ' *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safe S"License: Bus.TeL No. Alt.Tel.No.: 3 Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage ormally 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:$