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Home My WebLink AboutBLDE-23-003027 e0. Commonwealth of Official Use Only 'I . Massachusetts Permit No. BLDE-23 003027 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:12/2/2022 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 4Nribed below Location(Street&Number) 46 SUMMER ST _ Owner or Tenant STARRATT ROBERT J �r�� hone o. 2�`� ' � Owner's Address STARRATT RUTH S, 27 HINCKLEY RD, WABAN, MA 02468-1703 Telephone No. 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 gNo.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: Kitchen and bath remodel, HVAC wiring, 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 Aboved. ❑ In- ElNo.of Emergency Lighting grn grnd. 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 Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 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 Ballasts Signs Data Wiring: 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 of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Timothy Robery Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 57427 Address: 1 Carol Road,Buzzards Bay MA 02532 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 5083640419 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 thecheck one)) ❑ owner ❑ owner's agent.Owner/Agent Signature Telephone No. I PERMIT FEE: $75.00 I /.3,4474 2. .)44 s 1 Ki r`c,4 6.,N 1¢ne4 47/4 iL/9/23 ?. N72 4 ( \rl A. 7I3(23 k (4 :-2 £/,vj �;1 i• (_, 7/l((-v & DEC 02 2022 c ',wealth ol aeac�udat le Official Use Only Bc�C; iNG UEPARTME e,;� AoD;ia ,L9 Permit No.%svartmani of-}fire . eovicse�^ ! ti ,� ��` BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked APPLICATION FOR PERMIT TORev. 1/07)_ leave blank All work to be performed in accordance with rhe chusetts Electrical Code PERFORM E�M_CTRICA.0 WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) > 5 cMR 12.) City or Town of: YARMOUTH Date: , By this application the undersigned gives his or her to perfo theTo the electrical ical wok•escr Location(Street&Number) escribed below. Owner or Tenant / - d i G1-7f 4 ' l o Owner's Address ��' / ' / T phone No, j Is this permit in conj coon with a building permit? Yes ❑ No J Purpose of Building (Check Appropriate Box) I ' Utility Authorization No. •\ Existing Service Amps / Volts Overhead � Ne`v rvice Undgrd C� No.of Meters �� 5----- Amps / Volts Overhead 0 Undgrd E Number of Feeders and Ampaclty g t_ No.of Meters CLocation and Nature of Proposed Electrical Work: l \ i)c , .— 4..., 4 4.2 VI Completion o the a[lowinp ' ' C.la"Z � A No.of Recessed Luminaires able m be waived b the In ector o Wires. No.of Ceil:Susp.(Paddle)Fans '°•° ota t`., No.of Luminaire OutletsTransformers KVA No.of Hot Tubs Generators KVA $ No.of Luminaires Swimming Pool ,nnd.i Q •°'° Units cy g mg rove rnd. Q Batte Units ;f No.of Receptacle Outlets No.of Oil Burners No.of Switches FIRE ALARMS No.of Zones ` No.of Gas Burner! `o.o l etechon an I, t ,L'-‘ ` No.of Ranges ota Initi'.atinQ _ No.of Air Cond. No.of Alerting Devices J No.of Waste Disposers 'eat ump Tons Totals: '`'per!er lai `et o car- onta ne No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW ❑ Conne un c No.of Dryers Heating Appliances Local ction El Other `o.o "a er KW ecur ty ystems: Heaters KW `° ° O.o No.of Devices or Equivalent Si:ns Ballasts Data Wiring: No.Hydromassage BathtubsNo.of Devices or E uivalent No.of Motors Total HP a ecommun ca ons r ng: OTHER: No.of Devices or Equivalent Estimated Value of Electrical Wo Attachhen i detailm if desired,orc as required by the Inspector of Wires. es. Work to Start: to Ly ii�r_ JVhen required by municipal policy.) uested in INSURANCE COVERAGE: Unless waived by ns to the ogwaaer,nopermit for the performance ce with MEC lof ee lectric and al w rk completion.may ss the Licensee provides proof of liability insurance including thelicensee undersigned certifies that such cov "completed operation"coverage or its substantial equivalent The unless CHECK ONE: INSURANCEge is in force,and has exhibited proof of same to the permit issuing office. I certJfy,under the pains a d penalties.01 Oo fDe� OTHER 0 (S ci Pe fy:) FIRM NAME: p that the information on this application is true and complete. '*G 9 Licensee: / _ LIC.NO.: !a (If applicable,,enter"ex r�t^in the lice number line.) Signs re Address: -" _ LIC.NO.: *Per M.G.L.c. 147,s.57-61,securitywork requires De us.Tel.No.. t - - )(jig' OWNER'S INSURANCE WAIVER; I Department of Pu tic Safe Alt.Tel.No.: L 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/Agent Signature ]owner ❑owner's a ent. Telephone No. PERMIT FEE:$