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Home My WebLink AboutBLDE-23-002596 Commonwealth of Official Use Only 4. Massachusetts Permit No. BLDE-23-002596 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:11/10/2022 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) 10 TIMBER LN Owner or Tenant FITZPATRICK JAMES E Telephone No. Owner's Address FITZPATRICK MARLENE F, 10 TIMBER LANE,WEST YARMOUTH, MA 02673 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: Miscellaneous work per attached 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- CINo.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 Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 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: Richard T Mckenzie Licensee: Richard T Mckenzie Signature LIC.NO.: 28006 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:55 BARQUE CIR, SOUTH DENNIS MA 026602359 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 U ....,,_ Commontveatth ol U/addachuckith Official Use Only / �aioarfinanl o`,}i,a J Permit No ram- (o amicas ,,, BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked V APPLICATIONRev. 1/07] leave blank i FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR t2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) To the-1;;;ctorop , 1 City or Town of: v Date: //-9- �„2�- Q By this application the undersigned gives notice of ARMhOUTHention to perform the electrical wo ddes Location(Street&Number) /' T- �, scribed below. Owner or Tenant �/� �� f� Owner's Address Q�i� c� Telephone No.c�G 7T�/®�� . .� yi Ai Is this permit In conjunction with building `tee'd3 3G 6cr � Purpose of Building permit? Yes ❑ No 0 (Check Appropriate Box) !9/F�?C_ Utility Authorization No.aisting Service ---2e '.) Amps /...159 /Z !'t N Volts Overhead ElUnd rd w ervi a Amps / g 0 No.of Meters V Volts Overhead 0 Undgrd El No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: U e, ,z, .. r No,of RecessedCom,letion o the ollowin.table m be waived b the Ins,ector o Wires. I. Luminaires No.of Ce11.-Susp.(Paddle)Fans T o.o No.of Luminaire Outlets Luminai Transformersota No.of Hot Tubs KVA -1` No.of Luminaires Generators KVA Swimming Pool ' 've n- 'o.o roes enc �� No.of Receptacle Outlets rnd. nd. 0 Butte Uai s y g ng • No.of OH Burners FIRE ALARMS No.of Zones • ti No.of Switches No.of Gas Burners `o.o etec on an 1`rInidatin_ Devices No.of Air Conti. ota Na of Waste Disposers p Tons No.of Alerting Devices 'eat 'um um er ons `o.o Totals: ......_...._...._._.........................._. " e out: ne • Na of Dishwashers Detection/Alerts • Devices Space/Area Heating KW 'un ccti a No.of Dryers Heating Appliances Local Conneon �� 'o.o "a er KW eca ty ystems: Heaters KW 'o.o lasts No.of Devices or E•uivalent Si;ns Bal Data Wiring: No.Hydromassage Bathtubs Na of Devices or E•uivalent No.of Motors Total HP a ecommun ca•ons " r p g: OTHER: No.of Devices or E E.uivalent Attach additional detail if desired,or as required by the Inspector of Wires, Estimated Value of Electrical Work: Work to Start: //-9_Z2 (When required by municipal policy.) SURANCE COVE Inspections to be requested in accordance with MEC Rule 10,and upon completion. RAGE: 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 undersigned certifies that such cove ge is in force,and has exhibited proof of same to the permit issuing CHECK ONE: INSURANCE � equivalent. The I CHECK the pains and BOND 0 OTHER 0 (Specify;)t cw:�-q//,/ , office. FIRM NAME: ks°jperfury,that the Information on this `�� 3 7". '' • Z./ w application IS tr and complete. Licensee: -7 `�Aze. - /- (Ifs applicable, Signature LIC.NO.: /=f3f�g I'p enter"exempt"in the license number line.) Address: LIC.NO.:_ *Per*Per M.G.L.c. 147,s.57 S �/� , ;f Bus.Tel.No.: �� ER'S INSURANCE 1Wq security work requires De Alt•Tel. / Department of Public Safety••S�•License: No.: required by law. B �R: I am aware that the Licensee does not have the liability insurance coverage normally Y mysignature below,I herebywaive this requirement. I am the(check one • Lec.No. Owner/Agent Signature q y Telephone No. owner ■ owner's a.ent. PERMIT FEE:$