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Home My WebLink AboutBLDE-21-004777 ►� �� Com Offici ,h� monwealth of Massachusetts Permit No. BLDE-21-004777al Use Only 7 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:2/23/2021 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) 40 BENJAMIN WAY Owner or Tenant Sharon Fitzgibbons 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 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: AAddition&remodel 3 bedrooms& 1 bathroom. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 16 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 1 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- CINo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 26 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 12 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 1 Total 2 No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 6 Totals: Detection/Alerting 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 S-2%0 6:41. 11‘(-24 rg-- cam- C gal ll it/ . r C.) 14 Comasonteea&ol Me/mac/media Official Use Only c� c� Permit No. C — L{777 a '-. �CJsparf.,unt onus&m resd i BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked a [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ' All work to be performed in accordance with the Massachusetts Electrical Coda(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: )- ,?a - d 1/ 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) yU V E N��r»i.tif fAM- I Owner or Tenant S'/fjd`jDs.,J 547/ .f Z (r / 3 t?a.v S Telephone No.io r- 4/J --, So,5-s---- Owner's Address v Is this permit in conjunction with a building permit? Yes kr No 0 (Check Appropriate Box) '° Purpose of Building `S,'v�L/C F�,•71 i L Y Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters ' \ New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: 4-0 D i 70,,, _/4")%) iK,:n'O (l C L a .3- 2t<0 a-0 ann f- l3/r/4 \ILCompletion of the following table nip,be waived by the In vector of Wires. No.of Recessed Luminaires / No.of Ceil.-Susp.(Paddle)Fans No.os Total Transformers KVA t No.of Luminaire Outlets No.of Hot Tubs Generators KVA e CA No.of Luminaires SwimmingPool Above In- No.of l;mergency Lighting grad. ❑ grnd. ❑ Battery Units ti No.of Receptacle Outlets a G No.of Oil Burners FIRE ALARMS No.of Zones No.of SwitchesNo.of Detection and • / No.of Gas Burners Initiating Devices 113 No.of Ranges No.of Air Cond. Tons) No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons W No.of Self-Contained Totals: ' ` �` """`""""'M"' Detection/Alertin Devices No.of Dishwashers Space/Area HeatingKWMunidp p Local 0 Connection ❑ Orllet' No.of Dryers Heating Appliances KW becarrty Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP ' Telecommunications Wiring: No.of Devices or Equivalent OTHER: ico 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:,v - ,_a, / Insp tions to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVI±,RAGE: 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 (r 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: jIJ ud!K2' Signatur I �/� ott., LIC.NO.: ��d ► (If-applicable.enter"exempt'in a license number line. �!/�'E Address: /�/s-�~X (`� Ala � Bus.Tel.No.; *Per M.G.L.c. 14 ,s.57-61,security t workqu / D��/ Alt.Tel.No.: f/} j -/�jYt'j rtY requires Deparhnent of'�b is Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I 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 Owner/Agent (check one)0 owner 0 owner's agent. Signature Telephone No. I PERMIT FEE:$ /SO .6 f