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Home My WebLink AboutBLDE-22-006478 -• .,,..r , Commonwealth of 8official Use only Massachusetts Permit No. BLDE-22-006478 a�v 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:5/11/2022 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 MASSASOIT RD Owner or Tenant BALTAZAR MARIA A TR Telephone No. Owner's Address THE REVOCABLE INDENTURE OF TRUST, 18 MARION CIR, LUDLOW, MA 01056-1552 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 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: R&R all exterior fixtures for vinyl siding installation. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cei►:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ grnd. ❑ No.of Emergency Lighting Bery 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 ❑ 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 ,,„ Sims 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 ❑ BOND ❑ OTHER 0 (Specify:) 7178' ZS 6•'651 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: John D Gilbride Licensee: John D Gilbride Signature LIC.NO.: 15886 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 21 PROGRESS AVE,UNIT 2,CHELMSFORD MA 018243600 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: $50.00 Commonwealth o/Mai sachu.4etta Official Use Only __ _ l wiz-4%447 a cc�� c�'77 Permit No. -:e .2epartment o�,}ire Service3 Occupancy and Fee Checked -� BOARD OF FIRE PREVENTION REGULATIONS �� [Rev. 11071 (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: OU 113 I 71 City or Town of: ec-‘ *),Y((1 1 To the Inspecor of Wires: By this application the undersigned gives notce of his or her intention to perform the electrical work described below. Location(Street&Number) t r MG/SS 0✓ S 61-k" C d Owner or Tenant frr (3Q� +(\9-c r Telephone No. 14 3)315 -63(A Owner's Address `t Iqassoso.l t d \j p \I(N ib(Witl ( MIN 1 02*113 Is this permit in conjunction with a building permit? Yes 4 No (Check Appropriate Box) Purpose of Building es0Qf\11rrt Utility Authorization No. N/A Existing Service Amps / Volts Overhead ❑ Undgrd g n No.of Meters New Service Amps / Volts Overhead n Undgrd g n No.of Meters Number of Feeders and Ampacity Lo ation and Nature of Proposed Electrical Work: t fur uln�j S)(.1rn9 t sial(a. are. Y� /um, £.c hi ron/� t,iy . 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 grnd. grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices Tot No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: i l Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal ❑ Connection ❑ Other No.of Dryers Heating Appliances , Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW 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: �r' Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 'LU0(Q(j (When required by municipal policy.) Work to Start: 0516 J 1 ��u Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVRAGE: Unless waived by the owner,no permit for the performance of electrical work the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The unless undersigned certifies that such cov rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pas a d penalties o. perjury,that the information on this application is true and complete. �G FIRM NAME: (11110 (.�f. PI C Cane` 0 LIC.NO.: W Licensee: Jpkft D, ]i !him Signature Cgil(If applicable,enter " empt"in the licens numb r lin . LIC.NO.: Address: ? uc're ss Np \-re R.) VH Si -ei NA r t L Bus.Tel.No.• *Per M.G.L.c. 147,s.5Y-61,security work requires Department of Public Safetyy Alt.Tel.No.:� 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 ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ I