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Home My WebLink AboutBLDE-22-005829 tom- 0\\\\ Commonwealth of Official Use Only /I , Q Massachusetts Permit No. BLDE-22-005829 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:4/12/2022 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) 58 RAINBOW RD Owner or Tenant CIESLIK RICHARD T TRS Telephone No. Owner's Address CIESLIK MARY R TRS,29 BRIARWOOD RD,WALTHAM, MA 02452 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: Remodel kitchen&bath. Replacement HVAC. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 4 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 12 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 8 No.of Gas Burners 1 No.of Detection and Initiatine Devices No.of Ranges 1 No.of Air Cond. 1 To No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alertine Devices No.of Dishwashers 1 Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* rY 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 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: EDWARD M LYNCH Licensee: Edward M Lynch Signature LIC.NO.: 35609 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 WIDGEON LN,WEST YARMOUTH MA 026733818 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 L ! Iaf2(Re:4E7-0 Low ?4L RECEIVED APR 12 LU2 o ea&o f/fJaddachuesfffie Official Use Only ZZ e2/ 7 - c'� Permit No. 6�v DING D E PA R f Enuntt o }irs sirvfcsd I - Occupancy and Fee Checked ,,, =• ' ' • • F RE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM EL CT ICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( C),7M .O0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ('�` Lr �-+ City or Town of: YARMO TH To the Ins'p f Wires: By this application the undersigned tv s no a of his r her inten'0. to /orm the electrical work described below. Location(Street&Nu er) I u'I 54 r Owner or Tenant '`G�Qt G r P 1 Telephone No. t Owner's Address POI ve Is this permit in conjunctio/�with ariling permit? Yes No 0 (Check Appropriate Box) Purpose of Building //L(/Pj ,4Utility Authorization No. Existing Service (eV Amps ` 2 fokilts Overhead Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead Undgrd g ❑ No.of Meters Number of Feeders and Ampacity I Location a d Na a of Propose91 Electrical Work: vl 149 ciee 11G5 S' P47, L Completion of thefollowingtable may be waived by the Inspector of Wires. 11. No.of Recessed Luminaires No.of Ceil.-Sasp.(Paddle)Fans No.of Total `.j Transformers KVA cx No.of Luminaire Outlets No.of Hot Tubs Generators KVA . No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grnd. grnd. 0 Battery Units �` No.of Receptacle Outlets 1 No.of Oil Burners -.: FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners /1Vo.of Detection and ~ Initiating Devices 11` No.of Ranges / No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Dear Pump I Number!Tons 1 KW No.of Self-Contained Totals: f Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipa Connection ❑ Other No.of Dryers / Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Valu of I c i I Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE VE GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides oof 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 1;ec 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: LIC.NO.: Licensee: Signatures LIC.NO.: 5^ -�e (If applicable,enter•'exe tr t"i r l'e e nw rber lit ) Address: ?-S�jfi/ p. (� � (f'ft/oti7'/ /, �f� Bus.Tel.No. p*Per M.G.L.c. 147,s.57,(61,security work requires Dent of Pub Safety" "Licedse: Ait.Tel..1No.�'��31J OWNER'S INSURANCE WAIVER: I ty 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 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ I ;'N