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Home My WebLink AboutBLDE-22-002309 41 Commonwealth of Official Use Only op Massachusetts Permit No. BLDE-22-002309 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:10/22/2021 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) 42 RIVER ST Owner or Tenant MAZZIE STEVEN A TR Telephone No. Owner's Address MAZZIE FAMILY TRUST, 129 BELL ROCK STREET, EVERETT, MA 02149 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: Replacement panel 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. Batten'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. TTootaln No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 Signs No.of Devices or Equivalent 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: $50.00 l� e felt36.4 RECEIVED OCT 212021 '1. C. a' / 1 ,nwea[th oI Maaaachads�a Official Use Only _ :�� !ING DEPARTME -..--1----2--..--- 0 c/ -;:-1.7.,(6` --_ c7 Permit No. L ,.:-.: - artmsnt o�.}ipe�irvicse c x,1,1 r 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(MEC).527 CMR 12.00 C (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /�, 9) � City or Town of: YARMOUTH To the Insp for of ices: / (,,J`� By this application the undersigned gives notice of his or her intention to perform the electrical work described below. �v Location(Street&Number) 4/„.) ,2,0,:,,z._ ._S" Owner or Tenant 517—/E-6/(C' ,-7/9 e Z / ./4". Telephone No. C/2 -. 6/—_5?-,j_7 _,' Owner's Address LI Is this permit in conjunction with a building permit? Yes ❑ No Ey (Check Appropriate Box) Purpose of Building 5 ti)r` 7-----72-r) 1 ))/ Utility Authorization No. ,•.fExisting Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampadty Ni Location and Nature of Proposed Electrical Work: 7 , l �d1 r,--it" L- (,G, , Ili /Lit: 1,i / S-C 7-47)1 P PO 4''t 2 Completion of the followinktable m be waived by the Inspector of Wires. ��.,: No.of Recessed Luminaires No.of Cell:Snsp.(Paddle)FansNo.ofd Total r': Transformers KVA ''-',1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. and. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of Detection and No.of Switches No.of Gas Burners No. Initiatlng Devices Tot 1 No.of Ranges No.of Air Cond. ons No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ °ther No.of Dryers Heating Appliances KW Security Systems:''' No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Sims Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: ‘,v Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: J' (i,, (When required by municipal policy.) Work to Start: /t� , /2 / Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C E G 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 Or BOND 0 OTHER ❑ (Specify:) I certify,under the pains andijenalties ofperfury,that the Information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: JL/•.)/n: i1?//: t Signature if cc 34" Li 6 (If applicable,enter" mpt'"in the li nse number lute.) LIC.NO.: Address: r �} �/ 1. >uit us Tel.No.: '] *Per M.G.L.c. 147,s.57-61,security wok requires Department of Public Safety'S"Lice se: Lie�No. �/ "] �) I 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ ,S C. '