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Home My WebLink AboutBLDE-21-007266 Commonwealth of Official Use Only €. '44Massachusetts Permit No. BLDE-21-007266 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:6/15/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 11 BAY RD Owner or Tenant OCOIN JOHN P Telephone No. Owner's Address OCOIN NANCY P,22 WILLOWBROOK DR,WORCESTER, MA 01609 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: Install conduit, in ground,for future sub panel in barn. 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/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 Data Wiring: Heaters 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: (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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 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 E & J elt0(71 _ l,oinnwnwaa ofad,�/ ,(fd Official Use Only >i: nn Permit No. f— —7? ei,._ �[cc771�spartanani o1.7 ire Jirviced 1 `iq 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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 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. Pd- Location(Street&Number) // j3istY DD $50.00 Owner or Tenant 'ji1 1�.w,sv e Y O'Co iA/ Telephone No.S'o'-7J f-7j ' Cid 11-- Owner's Address //.8R/ R i) G;e...1-7- Al iamo 7-il Is this permit in conjunction with a building permit? Yes Nop�� , 0 (Check Appropriate Box) /AL— Purpose of Building c$725/l e) ,Qt¢,/� Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: To PL4C4 Ausgc/EgoLe TO C'e.UOcji 7/Y4') f ye g t,/4 PR9A)e.L /.u7 44/(A) 4 A f v i vet t. 11.47- ' L4 j- Completion of thefollowingtable titmay be waived by the Inspector of Wires. No.of Recessed Laminaiuea No.of Cell.-Seep.(Paddle)Fans No.of l Transformers KVA 42.1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA kNo.of Luminaires g rule Pool Above In- No.of Emergency Lighting gfond. ❑ itfl d. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.ofbetectlon and Initiating Devices 114 No.of Ranges No.of Air Cond. Toil Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Foss KW No.of Self-Contained No.of Dishwashers Totals:) `- —`-" Detection/Alertin Devices Space/Area HeatingKW Municipal Local❑ Connection 0 Other• No.of Dryers Heating Appliances KW Security Systems: '' No.of Water KW No.of No.of Devices or Equivalent Heaters No.of Data Signs Ballasts aof 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: 5/161, (When required by municipal policy.) Work to Start ,X✓. 41/) 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 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of pedury,that the information on this application is true and complete. FIRM NAME: Licensee: LIC.NO.: Signature LIC.NO.: (lf able,enter"exempt"in the license number line.) Address: Bus.TeL No.: TeL No. *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No.•• OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage norma ljy required by law. By my signature below,I hereby waive this requirement. I am the(check one ?:_owner IN owner's a:ent. Owner/Agent Signature �� C c,iA) Telephone No.So—7fg—,7 PERMIT FEE:$