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Home My WebLink AboutBLDE-23-001214 Commonwealth of official Use Only pior p Massachusetts Permit No. BLDE-23-001214 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:9/6/2022 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) 50 PARK AVE Owner or Tenant LILIEBERG CARL J III Telephone No. Owner's Address LILIEBERG LAURA J,908 LINDSLEY DR,VIRGINIA BEACH,VA 23454 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check •' z . a Purpose of Building Utility Authorization No. _ r r :� _ Existing Service Amps Volts Overhead 0 Undgrd 0 '-' New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Re-Bar grounding&temporary service. 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. To 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 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: PATRICK DAVITT Licensee: PATRICK DAVITT Signature LIC.NO.: 54551 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 121 Marshall St, Leicester MA 015241009 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:$100.00 '1 )) 12_ R C -)(z— k r€P la 1‘3(24 a.- _l 14 t.omm. of 1/ iaaa Official Use Only , 3, i21 .,v�r ..af 4 .S Permit No. , f BOARD OF FIRE PREVENTION try and Fee Checked REGULATIONS [Rev,1/07j (eve blank) 3 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC).527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 912.hoZL 4 City or Town of: WEST `IR v-rpt To the Inspector of Wires: 4 By this application the undersigned gives notice of his or her intention to perform the electrical work described below. 4 Location(Street&Number) 5G ?i Rv e • Owner or Tenant hPi..src Co...PE Ccw,s�-a.,,c.-ry ) Telephone No.(n/1 L/c j$ ') - Owner's Address N evt':O.J MS Is this permit in conjunction with a IQ 14` building permit? Yes 0 No E3^ (Check Appropriate Box) Purpose of Building Sink;,!E PAM l t. Utility Authorization No. NJ lA Existing Service N/FI Amps / Volts Overhead❑ Undgrd 0 No.of Meters 7. _ timundr. NIA Amps I Volts Overhead❑ Undgrd❑ No.of Meters -- g Number of Feeders and Amp arty ,J 14 a Location and Nature of Proposed Electrical Work: 1,�,y a r... vAHea C�rto.r,.rd yr -ra Co IC y3 tit.rp-K 1cool 0vez-ile4o dT Ice %.ra TD corms en Completion ofthef lknebtg table be waived by the I for of Wires. it No.of Recessed No.�C .(Paddle)Fans Ten o otal te Q No.of ''h Luusiraubre Outlets No.of Hot Tubs Generators KVA k No.of Luminaires SwimmingP ❑ I 0 *Battery UThdta cy Lighting No.of Receptacle°idiots No.of OH Burners FIRE ALARMS IN°.of Zones No.of Switches No.ofddating Ikvtcices ' Na of Gas Burners 1: No.of Ranges No of Air Card. Tons Tom No.of Alerting Devices Na of Waste DlspesecsIkatPump plumber I amber Tons I KW ,_`N S f-Contained Totals:No.ofJ Space/Area Heating KW Local❑ Alerdas Devices C n ❑Other No.of Dryers Heating Appliances No.of Water No.of KW Security � �or EquivalentHeaters ' Sys �1}�°'o, Data No ofDevices or .ulvakat T No.Hydromassage Bathtubs No.of Motors Total AP OTHER: No.of Devkes or , nt Estimated Value of Work: 1) vat) Attach additional detail if 4 or as required by Inspector of Wires, Work to start: 9/3E�ttr (When required by municipal policy.) INSURANCE COVERAGE: Unless tob the nquested o permit accordance with MEC Rule 10,and upon completion. the licensee provides proof of liability insurance including"completed' A��'the�of electrical wank may issa unless undo signed that such cov is in f , exhi proof coverage er its substantial equivalent. The CHECK ONE: INSURANCE , proof of same to the permit issuing office. j cm*,rradef tAe e� DI BOND ❑ OTHER [� ( ifj"•) FIRM NAME: enaides fp�ww,that the h�on this B tare and complete. Derr Emir.-T2ic LLL Licensee: Q LIC.NO.: L2S9g,1 (lf licabk.eater exempt in the&en a_ma. Itne.) Sett • LiC.NO.: 5 5 Bus.TeL No.: 77N Address: 1LI MA�cr�aµ S� t�tGES�s 9 ofj *PerM.G.I c 147,s 57-61,securely wonk requires Departmeat y Alt.TeL No.: OWNER'S INSURANCE WAIVER: lama of public "5"License: Lie No. required by taw. By my signaturethe Licensee does not have the ' normally Owner/Agentbatow,I hereby waive this liability insurance coverage normally Signature talaWit. I am the(check one ■ m owner ■owner's ,�.,t. Telephone No.