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Home My WebLink AboutBLDE-22-001625 Commonwealth ofOfficial Use Only 43107 I -%017‘" Massachusetts Permit No. BLDE-22-001625 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:9/21/2021 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) 6 WILSON RD Owner or Tenant COLEMAN JOSEPH Telephone No. Owner's Address COLEMAN JEANNE, 118 SHEFFIELD RD,WALTHAM, MA 02451 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 ❑ 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 panel, smoke detectors, lights, &outlets. 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 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 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: Joseph P Coleman Licensee: Joseph P Coleman Signature LIC.NO.: 22532 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 118 SHEFFIELD RD,WALTHAM MA 024512323 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 Commonwea/b(of 7addach.udsifd Official Use Only ® 1-1i a:f/ c� [ 1 ` B` .°° /�, s Permit No. j w. !1 ., . �[.Jsloartmsni of urs Serviced b4 N t' 11 Occupancy and Fee Checked 1 c ;� Il,�;,-' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) s I APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK . , t1. 7 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: Lu Cr City or Town of: YARMOUTH To the Inspector of Wires: m py this application the undersigned gives notice of-his or her intention to perform the electrical work described below. ation(Street&Number) /� Z,e,//50,4../ Rd 6 jbps,f t,/., -3-ace vr' t Owner or Tenant f�`/7,40/ �,.5,,A, �e.-e,,,,,,v4 I/ Telephone No. �i�`7�� 9eG--y Owner's Address 5,.:5) e A's* /�-r/„c—.. Is this permit in conjunction with a building permit? Yes ❑ No 1Y (Check Appropriate Box) Purpose of Building re:Pt'i�i�T/_L Utility Authorization No. Existing Service/c)C? Amps /9-> /. qt,Volts Overhead Undgrd❑ No.of Meters / New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampadty r Location and Nature of Proposed Electrical Work: /0,,�/.�/ ,, s'�� ,�P2� (2,' -‘25-5.—/,‘",/4-c_ �-I < iz'/7 58 t:- _ t/ T"S /J Completion of thefollowingtable maw be waived by the In vector of Wires. riso el No.of Recessed Luminaires /2 No.of Ceil.-Soap.(Paddle)Fans No.of Total l Transformers KVA '='t No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting fund. grad. ❑ Battery Units No.of Receptacle Outlets G No.of Oil Burners FIRE ALARMS INo.of Zones v. No.of Switches No.of Gas Burners 7110.of Detection and Initiating Devices 11 t No.of Ranges No.of Air Cond. / Total f Tons a No.of Alerting Devices No.of Waste Disposers Heat Pump I NumIber Tons KW 'No.of Self-Contained Totals: ••..__..._ Detection/Alerting_Devices No.of Dishwashers Space/Area Heating KW al Municipal ❑ Connection ❑ Other No.of Dryers Heating Appliances Kms, Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: 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 ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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 0 OTHER 0 (Specify:) I certify,under the pains and penalti s of perjury that the information on this application is true and complete FIRM NAME: "j ,s.4e % OW ."�6� iv S 2 � ', LIC.NO.: Licensee: /g, j . '. Signature /;� , 4 _ i LIC.NO.: n (Ifapplicable,enter"exempt"in the license numbe one.) �` S �� /- Address: Bus.Tel.No.• *Per M.G.L.c. 147,s.57-61,securitywork Alt.TeL No.: 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 Owner/Agent (check one)0 owner 0 owner's agent. Signature Telephone No. I PERMIT FEE:$ I