HomeMy WebLinkAboutBLDE-23-004320 or
Commonwealth of Official Use Only
11= �' 11 Massachusetts Permit No. BLDE-23-004320
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:2/6/2023
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) 2 FRANKLIN ST
Owner or Tenant BEATON TIMOTHY P Telephone No.
Owner's Address 90 ASPEN HILLS WAY SW, CALGARY,AB T3H 0G7
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
J 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: Rewire 2nd floor bedroom.
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 1 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 6 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 1 No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Ton
No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of Devices or Equivalent
Heaters KW No.of No.of Ballasts Data Wiring:
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 ofperjury,that the information on this application is true and complete.
FIRM NAME: Joseph Rego
Licensee: Joseph Rego Signature
LIC.l NO.: 14348
(If applicable,enter'exempt"in the license number line.)
Address:30 OLD MEADOW RD, BREWSTER MA 026312630 A Tel o.::
Allt.t.
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: 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 CI owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE:$75.00
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with el fr/aa�ac A , :,-• ;•
Official Use Only
• = '�' 3 1023 ��spartanoat o�`, J.srvicas4 Permit No. f �?7 '�
�••i \dr. EOARD RE PREVENTION REGULATIONS Occupancy and Fee Checked '_
r NG U PARTMENT
By.
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' OR`PERMIT TO PERFORM ELECTRICAL
WORKAll work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(P. E4SEPRIN7'1NINK OR TYPE ALL IIVFORM42I0
City : pet or Taws of: M Date: (9. 3+ a 3
i By this application the pads �1°givesOUT�'H To the Inspector of blus:
Location notice of his or her intention to faun the electrical work described below.
P (Street&Number) it ewito ir.: )111 _ .
Owner-or Tenant
4 Owner's Address Telephone No.
Is this permit in conjunction with a building permit? Yes ❑ No
Purpose of Bniidmg ❑ (Check Appropriate Box)
V Existing ServiceUtility Authorization No. •
Amps LVoits Overhead❑ Undgrd ervice `r Amps ! 0 No.of Meters
--�—Yolts Overhead 0 Undgrd ElNo.of Meters
Number of Feeders and Ampac{
•
Location and Nature �stare of Proposed Electrical Work;
No.of Recessed . . • dhe _ table
No.of Ceit, be waived; the Ins, fora >l�brs,
cusp.(Paddle)Fans o KVA
No.of Lnminaire Outlets T�nsformers
/ No.of Hot Tubs
No.of Luminaires Generators KVA
Swbmmiag Pool ',de ❑ L ,,ergency Era,un
No.of Receptacle Outlets d' � B ,`- • Units g
CI No.of On Burners
No;of Switches FIRE ALARMS No.of Zones
/ No.of Gas Burners 'o.o' e : , , a,
No.of Ranges 'little• :_ Devices
No.of Air Cond. To o ing Devices
No.of Waste Disposers •':
m _ ns
Totals:• •mp umber ons ' „ `o.o vTI oast ,
No.of Dishwashers De on/Merlin• Devices
Space/Area Heating KW Local❑ co'u, a 0 Oth
•
•
No.of Dryers nna
o.o "ater Heating Appliances era ,
KW No.of
Heaters KW
Si_ s Ballasts No.of Devices or - .uivalent
o•o •'o,o ' ta W evicts or ent
ahin .
No.Hydrotnassage Bathtubs
No.of Motors Total 1IP eeommaa c�•ores "intigg--.
OTSER: No.of Devices or -•nivalent
•
,:, Value of Electrical World A���onal detail if desired or as required by the Inspector of Wes.
� Work to start; �_3_�, 3 00 _ (When required by municipal policy.)
INSURANCE COVERAGE: U rnspections to be requested in accordance with MEC Rule I0,and
upon. the licenseeUnless waived by the owner,no permit for thecompletion.
0 undersigned
rovides proof of liability insurance including"completed performance of electrical work may issue Thunlee
('n certifies that such coverage � operation"coverage or its substantial
c CHECK ONE: NSURANCE
is in force,and has exhibited proof of same to theequivalent The
t1RANCE '� BONDpermit issuing office.
r certyy,under the pains and 0 OTHER 0 (Specify:)
L FIRM NAME: ' P altles ofPajrtr that the preformation on this application is true and complete
Licensee: `j LIC.NO.- oy yg ,
(If appli aabla�rset'exempt"in the!` Signature
Address: h1(> i v sire amber line.)
LIC.NO.,
l *Per M.G.L.c. 147,S.57-61a 3/ Bus.Tel.No.• _p i
INSU security work requires Department of Public SafetyAlt.Tel.No.:
OWNER'Sgc required by law. RANGE WAIVER: 1 am aware that the Licensee does not have the liability Lin.No.
it Agent By signature below,I hereby waive thist3' coverage n� o mal'" y
Owner! requirement. I am the(check one ■ owner
-1 SignatureIII owner's ,_.,,t,
U Telephone No. PERMIT FEE:$ -7.5-