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Home My WebLink AboutBLDE-22-000376 o Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-000376 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:7/21/2021 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) 29 MACKENZIE RD Owner or Tenant John Tierney 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 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install conduit for future generator. 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 Initiatine Devices No.of Ranges No.of Air Cond. Total 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 ❑ 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 Tierney Licensee: John C Tierney Signature LIC.NO.: 33987 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:48 Beaver St,Waltham MA 024537006 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:$50.00 /Lovett 0 Cerurr- 2/24./ . SL` commonwealth `y�j // t °/ ///aeeachueatte Official Use Only „-Rt` 7 --;rr, r: c� c7 2 spartmenf o� }�Spoked Permit N �.� D � �^ i, I f BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked—s--`--__ Rev. 1/07) leave blank -- APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK U All work to be performed in accordance with the Massachusetts Electrical Code(M(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) ),527 MR 12.00 City or Town of: Date: 0.1 YARMOUTH To the Inspector o Wires: By this application the undersigned gives notice of his or her intention to perform the lectrical work described below. �` Location(Street&Number) ..-•-, Owner or Tenant '"'1 '"" .it :Ft0 Owner's Address Telephone N -(�f Ct Is this permit in conjunction with a building permit? Yes -No S \) Purpose of Building " ❑ (Check Appropriate Box) I S eUtility Authorization No. Existing Service Volts Amps ! "— Overhead 0 Undgrd 0 No.of Meters New rvice Amps ____/ _Volts Number of Feeders and Ampacity Overhead❑ Undgrd 0 No.of Meters Location and Nature of Proposed Electrical Work: _ 4 til C:{�Ai t1;d'11 iL "�' Completion o the ollowin• table m be waived b the Ins.ector o Wires. 11 ev No.of Recessed Luminaires No.of Ceil.-Sasp.(Paddle)Fans T o.o ota r No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA ,i No.of Luminaires n ovd.e Swimming Pool ,rI ov ❑ •n 'o.o mergency g ng of Receptacle Outlets ' nd• ❑ Bette Units g No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches • No.of Gas Burners 'o.o i etec on an II' No.of Ranges Initiatin• Devices No.of Mr Cond. ota Tons No.of Alerting Devices No.of Waste Disposers 'eat 'ump `um•Inner ons • �M Totals: eo.t o e - onta ne, No.of Dishwashers Detection/Alertin, Devices Space/Area Heating KW 'un ci a No.of Dryers Heating Appliances Local❑ Connection ❑ Other `o.o "a er KW ecu ty ystems: Heaters KW o.o "o o No.of Devices or E•uivalent Sins Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Devices or E•uivalent No.of Motors Total HP a ecotnniunof en,ons " r v g: OTHER: No.of Devices or E.uivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of ctric 1 Work: Work to Start: `7 - -� hen required by municipal policy.) SURANCE C Inspections to be requested in accordance with MEC Rule 10,and upon completion. IN �'E 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 ,theun ned provides that such covers `completed operation' coverage or its substantial equivalent. The CHECK ONE: INSURANCE • force,and has exhibited proof of same to the permit issuing office. I certify,under the sins and penalties D ❑ OTHER 0 (Specify:) FIRM NAME: _ p rY, at the inform on on this application is true and complete. G- Licensee: � � `_+ y x. LIC.NO.: j' (ifapplicable,enter"exempt"in t e license number li lure Address: 1 LIC.NO.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safe Bus.Tel No. --` Alt.Tel.No.:OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normallyty"S"License: Lie.No. required by law. By my signature below,I hereby waive this requirement. I am the(check one Owner/Agent q Signature � owner ■ owner's a:ent. Telephone No. PERMIT FEE:$