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Home My WebLink AboutBLDE-21-005195 Official Use Only 4? ' Commonwealth of Permit No. BLDE-21-005195 �� Massachusetts Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev.1/07 APPLIC ATION FOR PERMIT TO PERFORM ELECTRIIC1A L WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), SASE PRINT IN INK OR TYPE ALL INFORMATION) Date:3/12/2021 To the Inspector of Wires: City or Town of: YARMOUTH his application the undersigned gives no ice o is orher men ion o pe orm e e ec nca work described below. :ation(Street&Number) 23 SCALLOP RD Telephone No. 'tier or Tenant SZCZUROWSKI ANDREW +ner's Address 298 BEACON ST#8, BOSTON, MA 02116 Yes 0 No 0 (Check Appre rite Box) :his permit in conjunction with a building permit? Utility Authorization No. ,.." rpose f Building Volts Overhead ❑ Undgrd ❑ No.of j e ers fisting Service Amps Volts Overhead 0 Undgrd 0 No.of Meters w Service Amps amber of Feeders and Ampacity cation and Nature of Proposed Electrical Work: Addition over garage, upgrade service,&add sub panel. Completion of the following table may be waived by the Inspector of Wires. of Total lo.of Recessed Luminaires 28 No.of Ceil. No.Susp.(Paddle)Fans 1 Tra offormers KVA Generators KVA No.of Hot Tubs Jo.of Luminaire Outlets In- No.of Emergency Lighting rnd. Above ❑ .rnd. ❑ Batter Units . Qo.of Luminaires Swimming Pool - FIRE ALARMS No.of Zones No.of Oil Burners Vo.of Receptacle Outlets 38D of No.of etection and 19 No.of Gas Burners 1 I Devices 4o.of Switches No.of Air Cond. 1 Total i.5 No.of Alerting Devices No.of Ranges Tons 6 Number T�®No.of Self-Contained Totals:Heat Pump -Detection/Alertin. Devices No.of Waste Disposers Local 0 Municipal 0 Other: Space/Area Heating KW Connection No.of Dishwashers ms:* No.Security Sy uri ste Heating Appliances KW Sec Sec riDeviste or E uivalent No.of Dryers No.of Data Wiring: 1 KW No.of Ballasts No.of Devices or E uivalent No.tofo Water Si.ns Telecommunications Wiring: Heaters Total HP No.of Devices or E 1 uivalent No.Hydromassage Bathtubs No.of Motors OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. (When required by municipal policy.) Work to Estimated Value of Electrical Work: o start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. ration"coverage or its substantial equivalent.The undersigned certifies that such INSURANCE COVERAGE:Unless waived by the owner,noe permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed op coverage is in force,and has exhibited proof of same to the permit ERin❑g office. (Specify:) / Licensee: John CHECK ONE:INSURANCE 0 BOND 0 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: John C Burke Signature Bus.Tel.No.: LIC.NO.: 50364 C Burke Of applicable,enter"exempt"in the license number line.) Address:45 DIX ROAD EXT,WOBURN MA 018016104 Alt.Tel.No.: *Per M.G.L.c. 147,s.57 61,security work requires that the Licensepartment s doeslic noshave the liability insurance coverage normally required by afety"S"License: 7 OWNER'S INSURANCE WAIVER:I am aware ❑ owner ❑ owner's agent. signature below,I hereby waive this requirement.I am the(check one) Owner/Agent PERMIT Telephone No. Signature 52 rat �` f �/ [ ��iie Official Use Only, / ✓ v � COMInWR/Vf6(�pL ^Kaw+w --�� ]S cc�� 7 ad6aC -2 t -fit 1. '/ 3 ,tins&m cas Permit No. ( � S �` `� � Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07} (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ,527 C R 12.00 �� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,3 /a 1 City or Town of: ' g. MA a T/-I To the Inspec or of ires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. _ Location(Street&Number) 4.3 SO L L6 P Owner or Tenant ,4„/i2/C.ti) (-S? e_Q o c.,t/`,' Telephone No. Owner's Address t Is this permit In conjun with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building 1 3/e /43www'!ie Utility Authorization No. ,¶7 9 3 3 S Existing Service /04) Amps 1 -6 l ,p-f15 Volts Overhead❑ Undgrd Er No.of Meters 3 New Service cla.l. Amps ,5 6 /„T LeV Volts Overhead 0 Undgrd[ No.of Meters / Number of Feeders and Ampacity 411 Location and Nature of Proposed Electrical Work: L)17 j ri'D.a♦ O t/^C,-c. (p-� GAr e, 4 .i D ri,a--s h ,C S /Z v 1't L 4—Ad v St./43 i— ,e-L Completion of the followingtable;up be waived by the Inspector of Wires. otal No.of Recessed Luminaires t $ No.of CelL-Snap.(Paddle)Fans / TTranssformers TKVA C No.of Luminaire Outlets No.of Hot Tubs ,- Generators KVA EA Swimu�ing Pool Above ❑ In- ❑ No.of Emergency Lighting t No.of Lunilnaire: / grnd. grad. Battery Units No.of ReceptacleFIRE ALARMS No.of Zones Outlets 36 No.of Oil Burners No.of Detection and No.of Switches 9 No.of Gas Burnes Initiating Devices "� Toth 1'a No.of Ranges ..— No.of Air Coral. Tons /�, No.of Alerting Devices GP Heat Pump Number 1 Togs KW _. No.offS Self-Contained No.of Waste Disposers Totals: No.of Dishwashers — Space/Area Heating KW elpvd Local 0 Connection 0 Other No.of Dryers Heating Appliances KW Secy Systems:* No.of Devices or Equivalent No.of Water ers KW No Signs Of No.of Data Balasts No.of DevicesDe or E ulvalent 1 TelecommunlcatIons W No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equirhent OTHER: cz, Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Elec 'cal Work: GO, (When required by municipal policy) Work to Start: to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE O 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 cov a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) n on this itFc lehh true and I certify►under the pains and penalties of perjury,that the a LIC.NO.: Licensee: _ )O FIRM NAME: Signatu tigia3/04/7LIC.NO.: ,C SO S�1 / L Pp/ ./ tdl'Z�� °' Bus.Tel.No.: Address:applicable,enter"exempt" y(j .1),‘� Aarempt in the ' nrnn 0er line.) `., r ft O 1 hG i Alt.Tel.No.: -3 i./—7t1-/98C1 *Per M.G.L.c. 147,s.57-61,security work requires Department of Publio afety S License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally t required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner El � agr Owner/Agent Telnnhone No_ I PERMIT FEE:$ C 4bb %mature Elliott, Ken From: Burke, Sheri <Sheri.Burke@childrens.harvard.edu> Sent: Thursday, August 26, 2021 8:21 AM To: Elliott, Ken Cc: John Burke; sab532@msn.com Subject: ELectrical Permits-CANCELLATION Attentions This email origi?.ates.outside of the organization. Do not open attachments or click.links unless you are sureth1 mail from.' a known sender and you know the content 1s;,safe Call the sender to verify 1f unsure a Otherwise delete t email. M.. Dear Mr. Elliott, Please cancel the electrical permits for the jobs listed below: 1 40 Benjamin Way-West Yarmouth, MA West Yarmouth,MA rat1ord Lane-Yarmouth Port, MA Thank You, John Burke Electrician License# E50364 1