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Home My WebLink AboutBLDE-222-000301 Commonwealth of Official Use Only 4) E111% Massachusetts Permit No. BLDE-22-000301 �-' 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:7/19/2021 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) 44 MARY DAVID RD UNIT 65A Owner or Tenant Elizabeth Rouillard Telephone No. Owner's Address YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check 'r• . ) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 .. • irk.e , New Service Amps Volts Overhead 0 Undgrd 0 N: If , Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace three thermostats. �tal t pCom letion of the following table may be ` 's or of Wires. �No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle) No.of Fans Transformers / A No.of Luminaire Outlets No.of Hot Tubs Generators A 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 Gas Burners No.of Detection and No.of Switches Initiatine Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Space/Area HeatingKW No.of Dishwashers Local ❑ Municipal 0 Other:Connection HeatingAppliances No.of Dryers PP KW Security Systems:*No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent Telecommunications Wiring: 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. required bymunicipal policy.) Estimated Value of Electrical Work: (Whenq P P y' 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: THIELSCH ENGINEERING INC LIC.NO.: 16657 Licensee: RALPH A CARROCCIO Signature (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 1341 ELMWOOD AVE, CRANSTON RI 02910 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 I Commoluvealth/� yy M/��/ Official Use Only o` aeeac ettd i*__ _ l [,�` ` �`7 Permit No. 1i_ 1 2e arlment o 3ire Jarviced =- — Occupancy and Fee Checked e '� A 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: 07/08/2021 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)44 Mary David Road Owner or Tenant Elizabeth Rouillard Telephone No. 774-327-9554 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of Building Residential Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd n No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace 3 existing thermostats Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil: P Sus Fans Tf Total�addle) Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Batten 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 Total Isv No.of Ranges No.of Air Cond. Tons No.of Alerting Devices p. Heat Pump Number Tons KW No.of Self-Contained -- 0 rn No.of Waste Disposers*ii Totals: Detection/Alerting Devices f > Municipal No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other 0 a) `fl Heating Appliances KW Security Systems:* Ln x -a No.of Dryers No.of Devices or Equivalent 4- u co No.of Water No.of No.of Data Wiring: 51 y Ln Heaters KW Signs Ballasts No.of Devices or Equivalent co - to No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNofDeieor qu Wiring: No.of Devices Equivalent E to u- OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: $405.00 (When required by municipal policy.) Work to Start:07/21/2021 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 informati n ' pplic ' is true and complete. FIRM NAME: Thielsch Engineering LIC.NO.: 16657A / LIC.NO.: Ralph Carroccio Licensee: PSignatu (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: 401-784-3700 Address: 1341 Elmwood Avenue,Cranston,RI 02910 tAl—'TeT. fa.-- *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)❑owner ❑owner's agent. Owner/Agent I PERMIT FEE: $50.00 Signature Telephone No.