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Home My WebLink AboutBLDE-23-003366 �'�,'� -IA Commonwealth of Official Use Only >�,.�t', \ ' `` Y Massachusetts Permit No. BLDE-23-003366 4.`.. 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:12/16/2022 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 l ctrical work s ribed below. Location(Street&Number) 18 SWIFT BROOK RD J ea eivr" Owner or Tenant lihkilieftIMIRES Telephone No. Owner's Address 18 SWIFT BROOK RD, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropr'ate Box)._ (06 Purpose of Building Utility Authorization No. t 1 Existing Service Amps Volts Overhead ❑ Undgrd 0 No.of ers New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace service, replace all switches/receptacles. Completion of the following table maybe 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 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 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 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: Robert J Conlon Licensee: Robert J Conlon Signature LIC.NO.: 11017 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:6 MULBERRY LN, BRIDGEWATER MA 023243599 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 alp- k/, q23 r (6-de- Gtur 64,i wo ceztv lv I r1,-- commo�uveafth oil///adeachuastis Official Use Only "s l' DEN i' ' �c�]7`r�� cc77 Permit No. EZ3 - 3 3 fob T 7= ,r apartment 43i Serviced B t}i L J i N(�. E Occupancy and Fee Checked WO RD OF FIRE PREVENTION REGULATIONS [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: 1 a,-r I s -p . 41) City or Town of: c.,,d �j fit\tM.vt.1/ -1 To the Inspector of Wires: l By this application the undersigned gives notice of is or her' tentio to perform the ele ideal work described below. Location(Street&Number) s t, .W� - b Owner or Tenant '^ Telephone No.5/ 5C)5-7 i/7Er Owner's Address Is this permit in conjunction with a building permit? Yes 0 No Check Appropriate Box) Purpose of Building aOQ S'3 C t C1C eo Utility Authorization No. / 6 7 ! 7 J S Existing Service !0/ Amps (o G /010/olts Overhead 0-�dgrd 0 No.of Meters U New Service ac30 Amps (old 1f(I Volts Overhead Undgrd 0 No.of Meters / Number of Feeders and Ampacity ?•- - bLocation and Nature of Proposed Electrical Work: P ave ow. /c io r t ' Completion of the f lowing table mav be waived by the 1 ctor of Wires. No.of Recessed Luminaires No.of Ce1L-Snap.(Paddle)Fans o.of oral Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA 0 No.of Luminaires Pal Above In- No.of Emergency Lighting JSwimming grnd. ❑ grnd. ❑ Battery Units C No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.o(Detection and No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Tonsl 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 HeatingKW Municipal p Local❑ Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: d Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 75 ✓ (When required by municipal policy.) Work to Start: 1 d-1?-a,1- 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 ❑ BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties oiler] ,th th f infor atio n this application is true and complete. FIRM NAME: G 'C/`lJL G t9,3 LIC.NO.: Licensee: Signature LIC.NO.: i(U 1 7 13 (If applicab e,enter"exempt"in the license number line.) Bus.Tel.No.: /� Address: Alt.TeL No.: 7? j 'o --» Q've) *Per M.G.L.c. 147,s.57-61,security work requires Department of Public 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 El owner's agent. Owner/Agent Signature Telephone No. (PERMIT FEE:$75,E I .6‘..Mo "i''C3s -3 7 j7