HomeMy WebLinkAboutBLDE-23-007264 (2) Commonwealth of Official Use Only
A I Massachusetts Permit No. BLDE-21-006235
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:4/28/2021
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) 8 MAYO RD
Owner or Tenant Brian Kearney Telephone No.
Owner's Address
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: Wiring for HVAC.
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 1 No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices
Tons
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 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 Signs Ballasts No.of Devices or Equivalent
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 ❑ BOND 0 OTHER 0 (Specify:)
1 certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: BRENDAN E DRISCOLL
Licensee: Brendan E Driscoll Signature LIC.NO.: 17303
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:83 NEWBERN AVE, MEDFORD MA 021556430 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:$75.00
i' cc 4i 7(
1 C e-eatu of///addahaldi Official Use Only
5
�} nt• trr Jrrad Permit No.Occupancy L Z�
and
BOARD OF FIRE PREVENTION REGULATIONS Fee Checked�' j (lave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed is accordance with**Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 21.04.22
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) 8 Mayo Rd
Owner or Tenant Brian Kearney Telephone No. 339.221.3753
Owner's Address
is this permit in conjunction with a building permit? Yes ® No 0 (Check Appropriate Box)
Purpose of Building Single Family Dwelling Utility Authorization No.
Existing Service Maps / Volts Overhead 0 Undgrd 0 No.of Meter
New Service Amps / Volts Overhead 0 Undgrd 0 No.of Motets
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install wiring for HVAC system
Completion of tree wrn�table ay be watvudbydmIa�.�r of Wires.
No.of Recessed Luminaires No.of C lL-Snap.(Paddle)Fans TIo.oTran formae Total
No.of Luminaire Outlets lNo.of Hot Tubs Generators KVA
No. twang
of Luminaires Swimming Pool Above ❑ i ❑ 14 � �
Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No..of Switches Na of Gas Burners No.o�Detection
and
No.of Ranges No.of Air Caul. Tons No.of Alerting Devices
Na of Waste Disposers Heat Pump Number Irons I KW No.of Self-Contained
Term Detection/ .i Devices
No.of Dishwashers Space/Area Heating KW Local❑ Ma - d I 0 Other,
No.of Dryers Heating Appliances KW Na of or Equivalent
No.of Water KW No.of No.of Dot
Heaters Slurs Ballasts No.of Devicesor llalvaleat
TelecommunicationsofDDarien
o Rart .
No.Hydromassage Bathtubs No.of Motors Total HPNo.of Devices or t
OTHER:
Attach addldonal detail Orde bad ores nsquir d by the Inspector of Wires.
Estimated Value of Electrical Work (When required by municipal policy.)
Work to Start: 04.22.21 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.
CHECK ONE: INSURANCE Cl BOND ❑ OTHER ❑ (Specify)
I cast7lfy,ander the pains and penaldes of peristrA that the infirm*"on this application Is tree and complete.
FIRMNAME: Driscoll Electric Co. , Inc. .:�NO A17303
Licensee: Brendan Driscoll Signattrre,, -�'" Lac NO.: E34220
{7/'applicable,enter"exempt"in the license number line.) Bus.Tel.No.:617-5 9 0—0 015
Address: 83 Newborn Ave. Medford, MA 02155 Alt.Tel.No.:
"Per M.O.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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 ID owner's agent
Owner/Agent
Signature Telephone No. I PERMIT FEE:$
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