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Home My WebLink AboutBLDE-22-004899 of Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-004899 ,11 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:3/7/2022 City or Town of: YARMOUTH To the Inspector of Wir : Ed By this application the undersigned gives notice of his or her intention to perform the electrical work described below. � '� ��./'� „/ SW ��1J Location(Street&Number) 41 NAUHAUGHT RD (•`r /L^tcj ��l Owner or Tenant CHIN JARROD J Telephone No. , Owner's Address LAWRENCE COLLEEN L, 30 HAWTHORNE RD, MILTON, MA 02186 Is this permit in conjunction with a building permit? Yes 0 No 0 (Chec. - a��OittiN (1Yw"' Purpose of Building Utility Authorization No. Existing Service 100 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 i Location and Nature of Proposed Electrical Work: Wiring as requested. Upgrade service. 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 0 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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent 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: Alan R O'Reilly Licensee: Alan R O'Reilly Signature LIC.NO.: 51570 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 LENTELL ST, SANDWICH MA 025632116 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 my signature below,I hereby waive this requirement.I am the(check one) ❑ owner 0 owner's agent. Dwner/Agent Signature Telephone No. PERMIT FEE: $75.00 (16 3 e W k (LAO 2:3 eP-_ (\9/1 3lottyt- V"----611;. (sm qw-) 1----c."4t- g C1'4-. G 3Ij1 -? roue) C IRECEIVED forr-nar.;uca(ri MAR 202 al Ma_._, 5u3e�5 Ot�eial Use Only a pc-frr.`rf of .' Scrrt;r 3 Permit n ` BuiLl�llvv a HART BOARD p FIRE PREVENTION REGULATIONS Occ�cy Lad Fee Checked -Rev. 1/D7] Rea„blank) APPLICATION FOR.'PERMIT TO PERFORM ELECTRICAL WORK.All work to be performed in accortnce with the Massachuserts Electrical Code(1yEC,527 Clv.12.1)0 (FLEA SEPR1?dT'1?v a�K OR ! i,ALL DVFORM4TION) Date: r City or Town of: YARVIOLTH Tor By IZcahon the the Inspect r of Wires: �i P t Llsdeiicr�ed fives notice of his or her intention to perform the electrical work desenbed below. Location (Str.eet&Number) Owner.or Tenant Owner's Address Telephone No f IS this permit Ill COnJLTIlCdDIl with 2 building � ri ` �permit? Yes 19 7 Cllecl:A r6 Purpose of Building l l ( PP Prim Box) . Ut?lity Authorization No. _1 9 1 Existing Service Amps ! 22JYolts Overhead' Undgrd: No. of Meters New Service b1 Amps i l l�!I(oVoits Overhead Undtr d ❑ Na. of Meters _i— Numb-er of Feeders and Aiapacity Location and Nat.-are of Proposed Electrical Work: i Corm ' n of the following table may be wmi+ed by the inspector of hTrrez No.of Recessed Lumin ;-es No.of Cei1 Stsp.(Paddle)Fans No.of Total e Transformers .KVA No. of Lym4na4r OIItle� INo.tf Hot Tubs C,=neratnrs EL'VA No_ of Ltznzinair►� S�immina Pool ov` In- No.of tJmergency Lagnpng I,. � end. ❑ BFttarY Ua* s ND. of Receptacle 0IIt?ei3 No.of Oil Burners FM AL-4iZh'I5 No.of Zany No, of Switches INa.of Gas Burners • a of Detection had No_ of Rangges Devices No. of Air Chad. Tn t Tons �No.of Aierdag Devices No,of Waste Disposers HestPnmp rrnber 'Tons IKW [ND. of Totals: elf-Contained No. of Dishwashers • Detection/1SlertiaQ Deviser Spacel.krea Heating KW• Local:0 NviBaalon P No. of D err Cganectiicip lather Heating App;fances , Security Systetas:r No. of titer No.of Devices or E uivalent No. of No.of Heaters KW 5ians Ballasts Data Wiring No. Hydromassage Bathtubs No.of Devices or E uivalent No.of Motors Total HP Teleco cations Wiring: Na o of f Devices or E uivalent OTRFR: Estimated Value of E ectrical Work Attach additional detail tf des-fret4 or as reyzir=_d by the Inspector of l res. � ' Estimated to Start: (When required by municipal policy.) INSURANCE to TC`E CO i spe�ons to be requested in accordance with MEC Rule 10,and upon completion. kGE: 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 coven e is in force,and has exhibited proof of same to the permit issuing orrice. • CHECK ONE: INSURANCE BOND ❑ OTI1TR S S I certify, under the Paz and penalties o ❑ ( Peci fY) r�'q� �"2��e"Z p fperjT�,that the irtforrnaiion on the application is tru and complete. ' FIRM NAME: a 4 LIG NO.: '°, Licensee: ep_ezl Signature (if applicable, eater "ee pt in the!'cease mb line) LIC.N O.: 51 0 Address: 1 Bus.Tel.No.: J Per M G.L.c. 147, s.57-61,security work requires D artmentlof Public Safety �.License: Alt.TeL N No. ,IeI;_417 — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nor e the liabilityLin.insurancec required . By my signature below,I hereby waive this requirement. I the(check one) coverage normally❑ owner ❑owner's a eat Signature Telephone No. PERMIT FEE: $ 7s—