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Home My WebLink AboutBLDE-22-005075 OP Commonwealth of Official Use Only � ...-14\ .Li .` 'I Massachusetts Permit No. BLDE-22-005075 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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:3/14/2022 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 electrical work described below Location(Street&Number) 9 LOCH RANNOCH WAY Owner or Tenant William Knight ` Owner's Address 9 LOCH RANNOCH WAY,YARMOUTH PORT, MA 02675 Telephone No. -3 fit, Is this permit in conjunction with a buildingpermit? Yes 0 No 0 (Check Appropriate‘on) Purpose of Building Utility Authorization No. '``'- ' , Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Mete New Service Amps Volts Overhead 0 Undgrd 0 No.of Mete/ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Kitchen, Bath,&living room. 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 rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiative Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Municipal Local ❑ Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent KW No.of No.of Ballasts Data Wiring: Heaters Siens .No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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 o , �T, er u that the information on this application is true and complete. FIRM NAME: HENRY LARKOWSKI Licensee: Henry Larkowski Signature Tel. NO.: 26990 (If applicable,enter"exempt"in the license number line.) Address:91 HOKUM ROCK RD,PO BOX 267,DENNIS MA 026380267 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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 Cl owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 W/51-21z/ , R F C E IVFD , � official Use only MA ''— - - Permit No. 22 5 l�7.5 S_... 2epar o f gips ServtttS B u t 11 t .i.7:'--: i , Occupancy and Fee Checked ' ' P r. OF FIRE PREVENTION REGULATIONS I/07] blank APPLICATION FOR-PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 I2.00 (PLEASE PRINT ThrINK OR TYPE ALL INFORMATION) Date: jilt c City or Town of: YARMOUTH To the Inspe or of W es_ By this application the undersigned givesAoticc of his or her int-.:.. to perfo the electrical w described below. Location(Street&Nu L �r) es r Cr kif5 f L - . , Owner or Tenant K.�f —tic 9 A I r - l l _.- Telephonev No. Owner's Address f Is this permit in conjunction vlth a building permit? Yes EZ No 0 (Check Appropriate Box) Purpose of Building [ ,0 Ir,S t'. Utility Authorization No. Existing Service Amps / Volts Overhead Q Undgrd D No.of Meters New Service Amps / Volts Overhead D Undgrd C No.of Meters Number of Feeders and Ampacity Location and Naturepf Proposed Electrical Work: i)t...770 1 f) --r J.` 4J,_ ( - A '- 2I Y t* �`.-- .i P Completion of thefollowinztable may be waived by the Inspector o Rim. No.of Recessed Luminaires No.of Ced.-Susp.(Paddle)Fans Tr °f TotalTransformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- No.of Emergency l.aghting g . grad. ❑ grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FLEE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tots! No.of AlertingDevices Tons .. No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: DetectionlAlertingDevices .� •No.of Dishwashers Space/Area Heating KW Local 0-Muni 0 Other _ Connection No.of Dryers Heating Appliances Kw Security Systems;* Heaters KW No.of No.of Data Wiring:No.of Devices or Equivalent No.of Water Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent O I'IiaR: Anark additional detail if desired or tsr required by the Inspector of Wires. Estimated Value lec 'cal Work /* / j (When requiredby municipal policy.) Work to Start: - Inspections to be requested in accordance with MEC Rule 10,and upon completion. J INSURANCE C GE: 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 issuin office. c.,1 CHECK ONE: INSURANCE BOND �f�t I ce under the 0 OTHER ❑ (Speci ) t� `( 3 a ram', pains and enatties ofperjury,that the information this application s true and complete. (Al FIRM NAME: LIC NO.: Licensee: t -- ��ie - LIC.NO.: ti(If applicable,e " empt"in the license number line.) . Address- f7 us.Tel No.• K' `Per M.G.L.C. 147,S.57-61,securitywork re t rQ Alt.Tel.No.: `! quires Department of Public afety ense: Lic.No. � r � — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n ly required by law. By my signature below,I hereby waive this requirement I am the(check one ❑owner owner's a y ORynerlAgent [ eat Signature l Telephone No. ( PERMIT FEE: ` _I