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Home My WebLink AboutBLDE-21-006543 a; "AO Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-006543 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:5/12/2021 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) 21 ACORN HILL DR Owner or Tenant William Flaherty Telephone No. Owner's Address 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 ❑ 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: Addition Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 1 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 5 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 Data Wiring: Heaters 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: 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: John C Burke Licensee: John C Burke Signature LIC.NO.: 50364 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:45 DIX ROAD EXT,WOBURN MA 018016104 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 signature below,I hereby waive this requirement.I am the(check one) 0 owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 U ceti S142,4 k- -- 1?-1 -111`irf CCIVAc 71(9 h-t a) h /2.,),, ...-) 7/t 3/2 f t s&'r 93Ac4 Lp ) • Commonwealth of Massachusetts Official Use Only Permit No. S 1 SJ ==1 't Department of Fires Services '.t- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS (Rev.9J05) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR I2.4)0 (PLEASE PRINT 1N INK OR TYPE ALL INFORMATION) Date: // ,2/ City or Town of: Y/9�o dy,4L To the Inspector of fires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below: Location(Street&Number) r 7/ A(y O2.,-„J ///1G Owner or Tenant l'//4,,.. /c/A 4 r .4, Telephone No. 6/7- 2S Owner's Address 5-78.° Is this permit in conjunction with a building permit? Yes No El (Check Appropriate Box) Purpose of Building_ 1;i it. /-gam'1 t/ Utility Authorization No. Existing Services Amps / Volts Overhead El Undgrd El No.of Meters New Service Amps / Volts Overhead n Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 4 aci. '1-‘"ii„i .............. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans / NTroansformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Aboae ❑ g eran-d. ❑ Bat efryU enitey Lighting ip'n No.of Receptacle Outlets J e^��"' No.of Oil Burners FIRE ALARMS No.of Zones • No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tr tl No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tate lf=Containe$ Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑Musiciaai Other Conu on No.of Dryers Heating Appliances KW Security S stems:* No.of Devices or Equivalent � No.of Wilier KW No.of No.of Data Wiring:.FFHeatersSigns Ballasts No.of Deies or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications wiring: No.of Devices or Equivalent OTHER: 01) Attached additional detail if desired,or as required by the inspector of Wires. Estimated Value of ec "cal Work: I))GOO, (When required by municipal policy.) Work to Start: �— Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COV GE: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 2 BOND El OTHER❑ (Specify:) I certify,under the pains and penalties of pedury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: ...-10Mkt/ Sae, C Sigma Sigmat LIC. NO.:£ Ci 3'4.-`/ (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: fs i;/ G6901,,D____A-v AV el t/2 *Security System Contractor License required for this work;if applicable, pabl,enter the license number there: No.:.Tel. ��'/�7ff y�J S� OWNER'S INSURANCE WAIVER:I a 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) n owner ❑owner's agent Owner/Agent Signature ___...._..._.... Telephone No. 'PERMIT FEE:$ ?S ��j t