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Home My WebLink AboutBLDE-22-006922 Commonwealth of BLDE-22-006922 Permit No. Official Use Only E� Massachusetts 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:5/31/2022 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) 9 LOCH RANNOCH WAY Owner or Tenant William Knight Telephone No. Owner's Address 9 LOCH RANNOCH WAY,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters • Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace panel&meter 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. grad• 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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KWNo.of Self-Contained Totals: Detection/Alertine 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 Siens No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent l 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: .HENRY LARKOWSKI Licensee: Henry Larkowski Signature LIC.NO.: 26990 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:91 HOKUM ROCK RD,PO BOX 267,DENNIS MA 026380267 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: $75.00 JC` t11KAN eg t'Acz- t 4'6 a (� 1 -1t I /� ---- -a., . 0 ECEIVEC mg1 122 �mnwruusaCllc of//lassac sslfs Official Use Onnlyp� �7� Permit No. l/ZZ—( 12� i` -- 2e artmani o f,}irs Services B U I L D I N _.: _-.�^ ENT P Occupancy and Fee Checked By 1i _' -_ a 9•RD OF FIRE PREVENTION REGULATIONS v. �� 1/07] (leave blank) APPLICATION FOR-PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(14,1EA 5 77 CMR 1 Do (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: l ?'2,._ City or Town of: YARMOUTH To the Inspec r of Wi es_ By this application the undersigned gives lice of s or her intention t rform the electrical work described below. Location(Street&Nu er) D L(//v�{ /. Sit Owner or Tenant W L L j 9 L 4 N t--/f'j-Telephone Nb. Owner's Address _ Is this permit in conjunction ' a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building 0,1(-7-- Utility Authorization No. Existing Service 2W Amps f)l KZ-pi/ohs Overhead a UndgrdX, No.of Meters / New Service ?(70. Amps/ W / ? Volts Overhead J Undgrd 25 No.of Meters Number of Feeders and Ampacity2- / 0 /' L v ,,�� /� Location and Nature of Proposed Electrical G e _ L—1 r -u. I / L=1_, Completion of the following table may be waived by the Inspector of Wires. IIsp,(Paddle)Fans No.oof Total KVA No.of Recessed Luminaires No.of Cell.-S Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool ornd. ❑ Qrnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners I FIRE ALARMS No.of Zones —No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges Na.of Air Cond. Tons No.of Alerting Devices No.of Waste D' users Heat Pump Number Tons KW No.of Self-Contained �p Totals: Detection/Alerting Devices Municipal No.of Dishwashers 5pace/Area Heating KW LOB❑ Connection ❑ OHier HeatingAppliances KW Security Systems:* No.of Dryers pp No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts _ No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP TelecommunicationsofDevices orWiring:q al y g No.of Devices or Equivalent OTHER: \J � (�� Attach additional detail f desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: gliC/ (When required by municipal policy.) ` Work to Start:fIS/4110 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 cov rage is in force,and has exhibited proof o ame to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Sue ' :) L..i_ G'�ii a Jd a �e3 `4 I certify, under the p•y and penalties of perjury,that the info • n on applicatmn plete. FIRM NAME- . , LIC_NO.: lb .. Mgt�a _ ,11Signatur WI ga;`'�� r ' LIC.NO. 2 6 (If applicabl-i./5 tempt"i thefif 7mme) ,. r /� r Bus.Tel.No.: Address: "1 (' VL / U j S �A- U7l13S Alt.TeL No.: J *Per M.G.L. c. 147,s.57-6I,security work requires Department of blic Safety"S"License: Lic.No. - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally `i required by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner ❑owner's agent. Signature- gnent Telephone No. PERMIT FEE: $ 7, 1 I { • 1` • I `