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Massachusetts Permit No. BLDE-22-001251
W. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.1/071
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•9/2/2021
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) 26 BAYBERRY RD
Owner or Tenant SINNOTT PATRICIA I Telephone No.
Owner's Address P 0 BOX 536, RHINEBECK, NY 12572
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&relocate track lighting.
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- o 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. Ton l No.of Alerting Devices
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 ❑ Municipal 0 Other:
Connection
No.of Dryers Heating Appliances Key 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: REILLY ELECTRICAL CONTRACTORS
Licensee: Sean Reilly Signature LIC.NO.: 22960
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 14 Norfolk Avenue, Eastson MA 02375 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
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,�� 2e artment o/.glee Services Occupancy and Fee Checked
" - BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
, C�1 ' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
L 2 All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
a (LEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: September 2, 2021
L'i City or Town of: YARMOUTH To the Inspector of Wires:
LSA i ('-) tt.is application the undersigned gives notice of his or her intention to perform the electrical work described below.
et/-----14.tion(Street&Number) 26 Bayberry Lane
6wrier or Tenant
Patricia Sinnott Telephone No. 607-342-0161
Owner's Address PO Box 536, Rhinebeck, NY 12572
Is this permit in conjunction with a building permit? Yes n No V (Check Appropriate Box)
Purpose of Building Residential Utility Authorization No.
Existing Service Amps / Volts Overhead ri Undgrd No.of Meters
New Service Amps / Volts Overhead n Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Kitchen remodel: relocate existing branch wiring for new layout
and install new branch wiring for added appliance. Relocate existing track lighting and update breakers as required.
Completion of the following table may be waived by the Inspector of Wires.
No.of Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA
KVA
No.of Luminaire Outlets No.of Hot Tubs Generatorse.ot EmergencyLighting
SwimmingPool Above ❑ In- ❑ g g
No.of Luminaires grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners
FIRE ALARMS INo.of Zones
No.of Detection and
No.of Switches No.of Gas Burners Initiating Devices
Total No.of Alerting Devices
No.of Ranges No.of Air Cond. Tons
Heat Pump I Number Tons I KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Alerting Devices
Municipal Other
No.of Dishwashers Space/Area Heating KW ALocal❑ Connection ❑
HeatingAppliancesSecurity Systems:*
No.of Dryers KW No.of Devices or Equivalent
No.of WaterNo.of No.of Data Wiring:
KW
Heaters Signs Ballasts No.of Devices or Equivalent
TelecommunicationsWiring:
No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: $3000 (When required by municipal policy.)
Work to Start:9/2/2021 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 ® BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information :n this aiplication is true and complete.
FIRM NAME: Reilly Electrical Contractors, Inc. _ LIC.NO.: 556 Al
Licensee: Sean Michael Reilly Signature �� j LIC.NO.: 22960-A
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:508-394-3211
Address: 14 Norfolk Avenue,Easton,MA 02375 Alt.Tel.No.:508-400-8936
*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)El owner El owner's agent.
Owner/Agent PERMIT FEE: $
Signature Telephone No.