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Home My WebLink AboutBLDE-21-002808 Commonwealth of Official Use Only 0 Massachusetts Permit No. BLDE-21-002808 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:11/17/2020 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) 23 SCALLOP RD Owner or Tenant SZCZUROWSKI ANDREW Telephone No. Owner's Address 298 BEACON ST#8, BOSTON, MA 02116 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: Septic pump&alarm. 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 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 1 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 Siens Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 1 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 perjuty,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: $50.00 /1 I ( ( ( g(w .� n � "� [.vmemarrtegta�si�wseerluteette Official Else2nl ' is. •, ccx�parbwtnE'h• .�*rvtese Pernut No. —C� a .lJ BOARD OF FIRE PREVENTION Occupancy and Fee Checked REGULATIONS [Rev. 1/071 (leave blank) 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 OR TYPE ALL INFORMATION) Date: / ��' 0City or Town of: //��p,a,,T !a To the Inspector o Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street do Number) 09? _SrA /7 Owner or Tenant fir.. 2,It 7 Li/,GwSKr• Telephone No. v! Owner's Address 4. Is this permit in conjunction with a building permit? Yes ®' No 0 (Check Appropriate Box) c Purpose of Building .S : r f t Cj1,,.,•'/ Utility Authorization No. V Existing Service Amps l a l /'r /A Volts Overhead 0 Undgrd 0 No.of Meters �_ New Service Amps / / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Anspacltl, Location and Nature of Proposed Electrical Work: ' Completion etnefolloiviveple be waived by the!vector of Wires. No.of Recessed Luminaires No.of CeiL-Saga.(Paddle)Face o.of T 24.1 Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA •#: No.of Luminaires S p� Above In- No.or Emergency Lighting mi� trod. ❑ crud. ❑ Battery Units :1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones s. No.of Switches No.of Gas Burners No.orDetecdoe and Initled:inDevices i No.of Ranges No.of Air Coati. Total Toes No.of Alerting Devices No.of Waste Disposers � ?dumber Tons KW NO.of Self-Contained _.� ��.._ . ...,_. Detection/Ak Devices No.of Dishwashers Space/Area Heating KW Load❑ Municipal onnectfon 0 "her No.of No.of Water 's Heating KW Nor YofSll>a •or Equivalent No.of No.of Heaters � Signs Ballasts Data Wiring: ' No.of Devices or ' ulvalent No.Rydromassaggee iBathtubs No.of Motors Total HP Telecommunications ' 1 1.. : OTHER: �)��l �7,� s No.of Devices or Eq t Estimated Value of Electrical Work: v J Attach additional detail if�red or as required by the Inspector of Wires. /Oo 6 i (When required by municipal policy.) Work to Start: /i /7 R C., Inspections to be requested in accordance with MEC Rule 10,and INSURANCE GE: Unless waived by the owner noW ckr> aytiss the licensee provides proof of liability insurance including.., permit for the performance of electri cal work may issue unless undersigned certifies that such coverage is in force,and has exhibited completed� coveragetothe or its substantialssing equivalent. The CHECK ONE: INSURANCE Er BONDproof of same to permit issuing office. !c�jy,under the0 OTHER 0 (Specify;) FIRMcotNAME: pains and penalties of' that the information on this application is true and complete. Licensee: -- � N , LIC.NO.: J U ifN ,�J2 /� Sigeature ^i LIC.NO.: r Sd`,c y (/f applicable,enter"exempt"in the license number lines) Address: Y5� 17,'Y v 47 5!7 A/o.?v2✓ /Yf� / �a 1 ,I Bus.Tel.No.:_ Alt.TeL No.: 7_ 5—/SS•sJ *Per M.G.L.c. 147,s.57-61,security work requires Department @('Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: 1 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 Owner/Agent owner's eat. Signature Telephone Na. PERMIT FEE:$5 1 ‘