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Home My WebLink AboutBLDE-22-003924 • ' , Commonwealth of Official Use Only t~.nli '' Massachusetts Permit No. BLDE-22-003924 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:1/14/2022 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) 11 BAY RD Owner or Tenant OCOIN JOHN P Telephone No. Owner's Address OCOIN NANCY P,22 WILLOWBROOK DR,WORCESTER, MA 01609 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 `5y.•rs New Service Amps Volts Overhead ❑ Undgrd 0 No. r Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Sub panel Garage. Completion of the following table may ha ' ns tor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.( )Paddle Fans No.of tal Transformers �� No.of Luminaire Outlets No.of Hot Tubs Generators ,tl'� ,A A No.of Luminaires Swimming PoolAbove ❑ 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 RECEIVED 202 o ` oak% h Official Use Only ^•.•wa addaC uda�d ie "' ___ J Permit No,l�Z ?JQ A �� LDING DEPART �� " nEo us erviced °v ' ' "' ' 'EVENTION REGULATIONS Occupancy and Fee Checked Rev. 1/07j leave blank is— APPLICATION FOR PERMIT TO PERFORM ELECTRICALW All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 WORK ' (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: YARMOUTH �--j �� ctor of Wires: By this application the undersigned gives o�M his OUTHintention to perform the eleectrical work descri Location(Street&Number) )' bed below. Owner or Tenant ; i y— j O C y,- Ci Owner's Address Telephone No. f yi��f�� Is this permit in conjunction with a building permit? Yes 0 No Purpose of Building— J4 (Check Appropriate Boz) O Existing Service 6� Amps / Volts Utility Authorization No. Overhead 6 Undgrd N �� Am sg ❑ No.of Meters �_ p / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty IThC Location and Nature of Proposed Electrical Work: k �tifrThetlonotIseollowinbm, bew . db ,e In .ector o Wires. 4r No.of Recessed Luminaires No.of Ceil.-Sus p (Paddle)Fans '°'o ota =t No.of Luminaire Outlets Transformers KVA �'\ No.of Hot Tubs Generators KVA ' No.of Luminaires ove n- 'o.o roergency g n Swimming Pool , nd. ❑ No.of Receptacle Outlets nd• 0Butte Units g No.of OH Burners No.of Switches No.of Zones s. No.of Gas Burners o.o 1 else on an 1 11 r No.of Ranges Initiatin, Devices No.of Mr Cond. ota No.of Waste Disposers 'eat 'Imp ' ers°s �, No.of Alerting Devices Totals: ..u uro.i.er o o.o e out ne No.of Dishwashers Detection/Alert Devices Space/Area Heating KW 'un c No.of Dryers Heating Appliances Local Connection 0 Other " KW ty ystems: o.o Hie lets KW o.o o o No.of Devices or I uivalent S ns Ballasts Data Wiring: No.of Devices or E'uivalent No.Hydromassage Bathtubs No.of Motors e ecommu, ca i ors " : Total HPg OTHER: No.of Devices or E.ulvalent Gt Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Wor , Work to Start: ----- (When required by municipal policy.) Jc_ _ _ spe tions 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: Licensee: LIC.NO.. (If applicable.enter"exempt"in the license number line.) Signature LIC.NO.: Address: Bus.Tel.No.:Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt,Tel.No.: Lic.No.OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability i surance coverage normally required by law. By my signs re below,I hereby waive this requirement. I am the(check one ►:/ owner ■ owner's a:ent. Owner/Agent s 1. Signature � .No Telephone D 6' �,j5 7 PERMIT FEE:$