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Home My WebLink AboutBLDE-23-001262 Commonwealth of Official Use Only / ,EE Massachusetts Permit No. BLDE-23-001262 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:9/9/2022 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) 35 KATHARYN MICHAEL RD U L/1`�i 1 — ( ( 2E- 744-.77445-- Owner or Tenant AVEZZIE JAMES L Teleph I e No. Owner's Address AVEZZIE SUSAN L, 145 INDUSTRY AVE, SPRINGFIELD, MA 01104 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: Generator installation. 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 1 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 of perjury,that the information on this application is true and complete. FIRM NAME: LEON KNIGHT Licensee: Leon Knight Signature LTC.NO.: 20979 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:9 PILGRIMS WAY, BREWSTER MA 026312061 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 ❑ owner's agent. Owner/Agent Signature Telephone No. I PERMIT F E: $75.00 (.0(7 1\17/1_ (at 16-4114 Ai) .(t)fittr_. 12 le id) 1 °( 6f - ' itt6Fii5E7T-exTztit9) '- r -GY 3Ia-) RECEIVED Commonwealth oi///aaaac!'iuestia Official Use Only SEP 0 �"�, c —1`Z�- ��,ri :Il 7 Permit No. =7A',7. F sivar�msnf o` }iro�srvicsd 4 f A Occupancy and Fee Checked B UILDING DE ,1 7'N1- BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) --- (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECT ICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ME ),527 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: a' '2.`Z-- City or Town of: YARMOUTH To the Ins for o Wires: By this application the undersigned gives notice of his r er intention to perform t elect ical work escribed below. Location(Street&N ber) / / Owner or Tenant / tie zz I.et `�a Telephone No. Owner's Address l Is this permit in conjunction with a buildingpermit? Yes ❑ No (Check Appropriate Box) IPurpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity t i Location and Nature of Proposed Electrical Work: C Ot kr t Completion of the following table my be waived by the Ins ector of Wires, ..A U. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA of CANo.of Luminaire Outlets No.of Hot Tubs Generators KVA rc‘ ,t No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting _grnd. Rrnd. ❑ 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. Totalo No.of Alerting Devices 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 ❑ OtherConnection No.of Dryers Heating Appliances KW 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 if desired,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 tSLBOND ❑ OTHER ❑ (Specify:) 1 certify,under the pins and na ies o ju that the information on this application is true and complete. FIRM NAME) XII (i�r1, el e r -(Ce /n �� A LIC.NO.:�>4 Z� ( /Licensee: �� n Jl� ((� ft Signature Of noplicabl nr a empt"in the licensjum a !i LIC.NO.: Address: 9s r Bus.Tel.No.• D *Per M.G.L.c. 147, 7-61,security wor uires Department of P bite Safety"S"LLiicense: Alt Lic.No. /I-3 OWNER'S INSURANCE WAIVER: I 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 Signature Telephone No. PERMIT FEE:$ 7 c-- I