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Home My WebLink AboutBLDE-22-006995 "` R . Commonwealth of Official Use only fi: 't Massachusetts Permit No. BLDE-22-006995 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:6/3/2022 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) 48 GREAT WESTERN RD Owner or Tenant KELLY RONALD J Telephone No. Owner's Address KELLY BARBARA J, 157 GREENWOOD AVE, RUMFORD, RI 02916 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: Replace service riser damaged by falling tree. 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 g bove ❑ In grnd. ❑ No.of Emergency Lighting rnd. - Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiative 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 Local 0 Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Euuivalent KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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, ./�P l,under the pains and penalties o perjury,u that the information on this application istrue and complete. FIRM NAME: Brian F Fisk Licensee: Brian F Fisk Signature Tel. NO.: 11523 (If applicable,enter"exempt"in the license number line.) Address: 130 CARPENTER ST, SEEKONK MA 027711105 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 Owner/Agent ) 0 owner 0 owner's agent. Signature Telephone No. PERMIT FEE: $50.00 qP47v RECEIVED E C E i �/ E ® tom '( -T-rn.Swt cct 16radci , L [ JUN 0 2 Ifti7 anunonw.a[pa o/ii'/aeeachivaah c� c� n �/OtFieial Use Only I L U t N G o a N T eparnunl o f.tu+r—Cervices Permit No. ✓ s� �, B U9 sy: ' . �+! BOARD OF FIRE PREVENTION REGULATIONS Occ 'pancy 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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: p ----�.=a'� By this application the undersigned givYAti e o O or man toH T oun theo e Inspectoreec work described Location(Street&Nu ber) ? cam4- below. 111 Owner or Tenant p N. Owner's Address Telephone No. U( Sp ( 3a-9 Ia this permit in conjoin on a building permit? Yes 0 No I� Purpose of Banding �ff� (Check Appropriate Box) Existing Service 2GDUtility Authorization No. Amps /a'`EO Volts Overhead I Undgrd❑ No.of Meters _4 ralgarist Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampadty COa Luca n d Nature of Proposed Electrical Work: Gr 0 s 11 ("`�_ ►�A •�(�.. Imo(" s Co ,letion o the ollowin_ table ph, be waived b the I . No.of Recessed .es tor o wires, Na of Ce 1.-Snap.(Paddle)Fans a.o KVA to C.) No.of Lumiaah a Outlets Transformers Na of Hot Tubs Generators KVA -t. Na of Luminaires Swimming Pool a ' d.e 0 n-d' ❑ Ba'o.oe `Uni cy n i ng No.of Receptacle Outlets No.of Oil Burners ne Unitsts Na of Switches No.of Zones No.of Gas Burners 'a o r ec.on an, tit 4. Initiatin Devices Na o Mr Cond. o Tons Na of Alerting Devices Na of Waste t ' mp ' . „ , Disposers n,, ,.er cos o.o Ya f Totals: `" - on. n Na of Dishwashers Detecdon/Alertin Devices Space/Area Heating KW Local ' n '� ers � Connecn tion 0 Other No.of �' Heating Appliances KW yams: a oHeaters KW 'o.o 'o•o Na of Devices or ' ,trivalent S a Ballasts No. Wiring: Na Hydromassage Bathtubs of D or ' ,trivalent OTHER: No.of Motors Total HP a Na of n, ;ons " r r : Devices or ' , eat Value of Electric Work: Attach additional detail)desired,or as requiredthe Inspector Work Estimatedo d Val -- (When required by municipal9 by of Wires. Inspections to bepolicy.) INSURANCE COVERAGE: Unless waived byto requested o accordance with MEC Rule 10,and upon completion the licensee E COVERAGE: of liability + permit for the performance of electrical work may issue unless undersigned licensedprovides ovi certifies proof such eov insurance including"completed operation"coverage or its substantial equivalent. The ,�, .'is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE I BOND 0 OTHER FIRM NAME: k i-i�-s-!>e�t1'nry that the n 't V app n e and complete. .: Licensee: r9� LIC.NO.: 0/applicable,enter" $ store Address: L 3t...) l' LIC.NO.: *Per M.G.L.c. 147,s.57-61, cp.'? Bus.Tel.No.• OWNER'S INSURANCE WAIVER:work aware that the Licensee does not have the (Alt.TeL No.: c a Departmentuires of Public Safety"S"License: Lic.No. Owner/Agent by law. By my signature below,I hereby waive this ui liability insurance coverage n 's a:e required Sivia n at requirement. I am the(check one ■ owner , ■ owner's a:ent. Telephone No. PERMIT FEE:$ Z) 0