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Home My WebLink AboutBLDE-21-007438 Commonwealth of Official Use Only `�` Massachusetts Permit No. BLDE-21-007438 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev.1/07 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL W RK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 vv O (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: YARMOUTH Date: Inspec021 By this application the undersigned gives no ice o is orher m en ion o e orm To the Inspector of Wires: Location(Street&Number) p e e ec ica work described below. GREEN CIR Owner or Tenant KOSTKA DANIEL E SR Owner's Address KOSTKA FRANCES J,60 CHIPPING GREEN CIR, SOUTH YARMOUTH, MA 02664 Telephone No. Is this permit in conjunction with a building permit? Purpose of Building Yes 0 No 0 (Chec ,7ropri• L Existing Service Amps Utility Authorization No. � z I New Service Volts Overhead ❑ Undgrd ❑ ' L1 Amps Volts t 4'rT��-�.� Number of Feeders and Ampacity Overhead 0 Undgrd 0 Location and Nature of Proposed Electrical Work: New circuit for microwave&relocate circuit for dishwa , ]�t-r '�j�sher. "WNW, - No.of Recessed Luminaires Completion of the following table may be waived by t��L= ,,r of Wire. No.of Ceil.Susp.(Paddle)Fans No.of No.of Luminaire Outlets Transformers �`1 No.of Hot Tubs KVA No.of Luminaires Generators KVA Swimming Pool Above In- rnd. ❑ _rnd. 0 No.of Emergency Lighting No.of Receptacle Outlets Batter Units No.of Oil Burners No.of Switches FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No.of Ranges Initiatin. Devices No.of Air Cond. Total Tons No.of Alerting Devices Heat Pump Number = Tons ® Totals: — No.of Self-Contained No.of Waste Disposers No.of Dishwashers MM.Detection/Alertin. Devices Space/Area Heating KW No.of Dryers Heating Appliances Local 0 Municipal 0 Other: Connection No.of Water KW Security Systems:* Heaters KW No.of No.of No.of Devices or E#uivalent No.Hydromassage Bathtubs Si ns Ballasts Data Wiring: No.of Motors No.of Devices or E E.uivalent Total HP Telecommunications Wiring: OTHER: No.of Devices or E#uivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work to start: (When required by municipal policy.) INSURANCE COVERAGE:Unless waived lby the owner,no permit isix for the perfonrmancce e of electrical MEC l v and upon completion. provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned coverage is in force,and has exhibited proof of same to the permit issuing office. work may issue unless the licensee CHECK ONE:INSURANCEg d certifies that such 0 BOND ❑ OTHER 0 I certify,under the pains and penalties o (Specify:) FIRM NAME: fperjury,that the information on this application is true and complete. MICHAEL J MCSHEFFREY Licensee: Michael J Mesheffrey Signature (If applicable,enter'exempt"in the license number line) Address: 1 LEONARD CIR, MANSFIELD MA 020482754 Alt.Tel.No.:LIC.NO.: 9897 *Per M.G.L.c. 147,s.57-61,securityrequiresp Bus.Tel.No.: OWNER'S INS work De artment of Public Safe S' URANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally re uired signature below,I hereby waive this requirement.I am the ) ❑ owner CI owner's agent. q by law.But (check one Signature Telephone No. PERMIT FEE:$50.00 Commonwealth o addac e i�__ .,/ c �c�77 Official Use Only * epartment o/,}ire�erviced Permit No. �1 �� 2 y =-, BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked �_,� [Rev. 1/07] (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 INK OR TYPE ALL INFORMATION) Date: June 21, 2021 City or Town of: YARMOUTH To theITITp-ZZT-Wires By this application the undersigned gives notice of his or her intention to perform the electrical work des abed below. Location(Street&Number) 60 Chipping Green Circle Owner or Tenant Daniel E. Kostka Sr. Telephone No. 508-737-1528 Owner's Address 60 Chipping Green Circle, South Yarmouth, MA 02664 Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building Residential ® (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps Volts Overhead Number of Feeders and Ampacity ❑ Undgrd ❑ No.of Meters Location and Nature of Proposed Electrical Work: Install new circuit for microwave. Move dishwasher circuit to under sink. Completion o the ollowin, table ma be waived b the Inspector o Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- `o.o mergency ig ing No.of Receptacle Outlets _rnd. .rnd. � Batte Units No.of Oil Burners [-FIRE — FIRE ALARMS No.of Zones 1 No.of Switches No.of Gas Burners 1No.of Detection and No.of Ranges Initiatin. Devices No.of Air Cond. Total j Heat Pump Number Tons Tons KW No.of Alerting Devices No.of Waste Disposers Totals: No.of Self- ontained No.of Dishwashers 1 Detection/Alertin. Devices Space/Area Heating KW 1Local❑ Municipal No.of Dryers Heating Appliances ecu Connection Li Other KWrity Systems. — —� No.of Water No.of No.of Devices or E i uivalent Heaters KWNo.of Data Wiring: Si ns Ballasts No.of Devices or E•uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E•uivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 6/21/21 Work to Start: $300 (When required by municipal policy.) Inspections 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. ONE: CHECKINSURANCE ® BOND I HECK the pains and penalties o El OTHER ❑ (Specify:) GENERAL ACCIDENT INSURANCE Ex certify, (perjury,that the information on this application is true and complete.p 07t31/2021 FIRM NAME: REILLY ELECTRICAL CONTRACTORS, INC. Licensee: MICHAEL J. MCSHEFFREY LIC.NO.:9897A (If applicable,enter "exempt"zn the license number line.) Signature LIC.NO.:9897A Address: 110 OLD TOWNHOUSE ROAD,SOUTH YARMOUTH,MA 02664 Alt.Tel No.::508-394-3211 C--- Bus.Tel.No..M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. 508-400-8936 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 ❑owner's a•ent. Owner/Agent Signature _ Telephone No. PERMIT FEE: $