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Home My WebLink AboutBLDE-22-000394 or Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-000394 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:7/21/2021 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) 29 MACKENZIE RD Owner or Tenant MAILikeTTITEKR=TRe Telephone No. Owner's Address mar -- — _. . c -- 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: Permit for final&to close out expired permit#E20-1607. 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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 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 ofperjury,that the information on this application is true and complete. FIRM NAME: John C Tierney Licensee: John C Tierney Signature LIC.NO.: 33987 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:48 BEAVER ST,WALTHAM MA 024537006 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 4J) e(qv t g4 Comnwnwea[tla o/Massaclusadis Official Use Only .B 'irl c� cc--�� n Permit No. 3epartmsni o/. ire Services 1 i_, Occupancy and Fee Checked •' ,,w ,,:`' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07].� APPLICATION FOR PERMIT TO PERFORM (leave blank) All work to be performed inaccordancewith the Massachusetts Elec cELECTRICA WORK N MA (PLEASE PRINT IN INK OR TYPE ALL INFORTIOM Date: -N. City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice ofhis or her intention to perform the electrical work described below. CO' Location(Street&Number) I. h'Vickeffv-at 2s5. Re.r)14) ce Owner or Tenant "Tv C.,.-r i et,a��,, Owner's Address Telephone N 7 >�jCt-�,i cf.S Is this permit in conjunction with a building permit? Yes t3"No t Purpose of Building1',� ❑ (Cheek Appropriate Box) S. fe f' i.t� e Utility Authorization No. V Existing Service Amps / Vo is Overhead New Service El Undgrd El No.of Meters c .)Amps 05a, Volts Overhead❑ Undgrd ''D -7 Number of Feeders and Ampacity g No.of Metera< Location and Nature of Proposed Electrical Work: E .- 0r 1. L%9�a� r / / Co� �JE � IV J � -' (flit Fi� GZt�^�(P��7 vv. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-Soap.(Paddle)Fans rffo.of Total Transformers No.of Luminaire OutletsansformersrA No.of Hot Tubs Generators KVA 4 No.of Luminaires Above In- No.of l mer enc Lighting Swimming pool Bind. ❑ and. ❑ Battery Units y g g ::-.i No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and t r No.of Ranges Total Initiating Devices No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers that Pump Number Tons XW 1TO.olSelf-Contained Totals: "__._._..._ ............._...._....._................. Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 un p No.of D ers Connection ❑ Other �Y Heating Appliances K�, ca ty ystems: o.o a Water o.o No.of Devices or uivalent Heaters it"' °•° Data Wiring: Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommun ca one g OTHER; No.of Devices or E uivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work to Start: (When required by municipal policy.) Lnspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waiv • .y the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability i ... ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coy le is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE N BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties ofperjury,that the in ormation on this app!' on is true and completer FIRM NAME: """--Gs '. t-'fie Licensee: LIC.NO.:4 3�v 2 I Signature LIC.NO (If applicable, me " m t"in the license Tiler i .) Address: Bus.Tel.No -GS! ?*Per M.G.L.c. 147,s.57-61,security work requires Departm t of Public Safety"S"License: Alt.Lic.No•: r. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insu ;• coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one re. owner ■ owner's a_ent. Owner/Agent Signature Telephone No. PERMIT FEE:$