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Home My WebLink AboutBLDE-22-006048 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-006048 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:4/21/2022 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) 53 WHISTLER LN Owner or Tenant MALZONE LOUIS F JR Telephone No. Owner's Address MALZONE KARA, 53 WHISTLER LN,YARMOUTH PORT, MA'02675 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 kitchen Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 12 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- o No.of Emergency Lighting gra grnd. Battery Units No.of Receptacle Outlets 10 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 5 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges 1 No.of Air Cond. Ton l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent 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 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: Bruce M Cofske Licensee: Bruce M Cofske Signature LIC.NO.: 11963 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 112 COHASSET ST,WORCESTER MA 016043241 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: $75.00 0e3AXoti Az e 1 1 I's + I n SCUICL✓i Cie . REC ,_ IV 'E ° APR20 .i. ', l.omn+onwaaa c/1//aQaa< sea fie ficial Use Only -� .sparinssnl°I.. firs�srvicse Permit No. BUILDING By __ _ 1•I I, � Occupancy and Fee Checked �^ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME 527 C R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: o/202.2. City or Town of: YARMOUTH To the Insp ctor of Wires: By this application the undersigned gives notice o his or h intention to)perform the electrical work desc ibed below.Po Location(Street&Number) Ay�� W ��? �— L- i.,e_ ,a.)�, o/- Owner or Tenant L.,O v\S M 0.L. 2 nt.i-C_ Telephone No.,O$ 7)6 O.2- Owner's Address S c t itA__ Is this permit in conjunction withikcb uilding permit? Yes E] No er—(Check Appropriate Box) Purpose of Building ?'J Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity iLocation and Nature of Proposed Electrical Work: !<c 1-c_ AJ Reii 0 4 rUr, Completion of the following table m be waived by the Inspector of Wires. << No.of Recessed Luminaires /'Z No.of Cell.-Sasp.(Paddle)Fans No.ofd Total Transformers KVA 't No.of Luminaire Outlets No.of Hot Tubs Generators KVA ^-t No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting and. and. 0 Battery Units :-} No.of Receptacle Outlets /Q No.of Oil Burners FIRE ALARMS JNo.of Zones --- No.of Switches No.of Gas Burners 'No.of Detection and — Initiating Devices c111 No.of Ranges / No.of Mr Cond. Total 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 KWLocal❑ Municipal ❑ Omer Connection No.of Dryers Heating Appliances KW Security Systems:/ No.of Water No.of Devices or Equivalent 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: cpNo.of Devices or Equivalent OTHER: C'2t 1>� 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: 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 covsfte is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 4� BOND 0 OTHER 0 (Specify:) I certify,under thsfains and penalties of perjury,that lie informatio on this application is true and complete. FIRM NAME: r v�p C.,,1�1� 4,r; c� p Cor ' a� c 1 Ly LIC.NO.: p Licensee: esee: I�>e� c--5'l Signature U`('�i LIC.NO.: I 15'6 ^�J applicable,en(gr"exep ft it the/teens umber Bate. Address: O ls'( (� b �JO k ,/J 0 2-5-3-6 Bus.Tel.No._�Pl j S� *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: All LiTel. .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 a,ent. Owner/Agent Signature Telephone No. p PERMIT FEE:$ 7s-,D