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Home My WebLink AboutBLDE-22-006637 Official Use Only ,,�^11 Commonwealth of _4 7ig% titli , Massachusetts Permit No. BLDE-22-006637 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:5/17/2022 To the Inspector of Wires: City or Town of: YARMOUTH 3y this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location,(Street&Number) 23 VIRGINIA ST Telephone No. Owner or Tenant O'ROURKE BRIAN J CO TRS Owner's Address O'ROURKE ANTONETTA M, 13 GREENMEADOW AVE, NORTH BILLERICA, MA 01862-1921 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 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA ov e No.of Emergency Lighting No.of Luminaires Swimming Pool grAbnd. ❑ In-grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Ton No.of Waste Disposers Heat Pump I Number I Tons KW No.of Self-Contained Totals: Detection/Alerting Devices ❑ Municipal No.of Dishwashers Space/Area Heating KW LocalConne Lion ❑ Other: Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or Equivalent NoNo.of No.of Ballasts Data Wiring: He Water KW Signs No.of Devices or Equivalent Heaters Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Eauivalent 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. OTHER 0 (Specify:) 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: JEFFREY T FOSS Signature LIC.NO.: 36938 Licensee: Jeffrey T Foss Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:33 SULLIVAN RD,.W YARMOUTH MA 026733543 *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 oliability inner urance owner'csoverage normally required by law.But my signature below,I hereby waive this requirement.I am the(check one) Owner/Agent PERMIT FEE: $50.00 Telephone No. Signature i (w a w/ I /nal RECEIVED 1- MAY 17 2022 aI :1 Co of aa6dacueatld Official Use O Iy awesttl& r-� `� -- -- ;' NG DtPARTM T Permit No. �J[�C—� �t/7 '"''l .'i — cc�� n�7 e _- ..... �� tmsnf o�.}in Jsrviesd + �: I-4 r BOARD OF FIRE PREVENTION REGULATIONS [ROccupancyev. I/07 and Fee Checked ] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELE TR AL WORK All work to be performed in accordance with the Massachusetts Electrical Code ) $?7 MR j.10 .� (PLEASE PRINT ININKORPEALLINFORTION) Date: �!�, City or Town of: YARMOUTH To tl:e Inspe or of Tres: By this application the undersigned gives n `tc of his or intention to perform the le trical work described below. •®/ Location(Street& ml�er) i ,j i ./ ' 0 I Owner or Tenant �� /: ,t�( Telephone No. "se —O p/4 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. ` Existing Service /00 Amps 1 W / 2t1Q Volts Overhead 0 Undgrd❑ No.of Meters ' New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty 5 t O1 c `--7 Locytio and Nature of Pr osed Electrical Work: pJ ' d� j 1 � a�s f jl'/,e ckr- v""t Completion of thefollowingtable may be waived by the Inspector of Wires. U. No.of Total : No.of Recessed Luminaires No.of Ceti.-Snsp.(Paddle)Fans Transformers KVA Zt No.of Luminaire Outlets No.of Hot Tubs Generators KVA K.::\ 1 No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grad. 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 11 No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices No.of Waste Disposers 'Meat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other, Connectionyyss No.of Dryers Heating Appliances KW Security f Devics:* es or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications o Equivalent Wiring: No.OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value o l tri 1 Work: '�'� (When required by municipal policy.) Work to Start: n d. Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RA E: 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 co erage is in force,and has exhibited proof of same to the pe it issuing office 9 CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) / L( e e J X/ �� r /� /' I certify,under the pains and penalties of perjury,that the information on this application is true an complete. FIRM NAME LIC.NO.: _ Licensee: ��t_. fro __ LIC.NO.: 6�3f� (Ifapplicable. xem t/"y'ythe rys�.nuffbf r{`ne,.� ,Q /4 ?/� 2 Bus.Tel No.: �Q� Address: , IV//t� 771/ W�T �arjF J / < IMtb�? Alt.Tel.No.:-�Vi/' 724, "�99 *Per M.G.L.c. 147,s.57-61,security work requires ep eat of P lic 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(check one)❑owner 0 owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.