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Home My WebLink AboutBLDE-23-005113 01111 Commonwealth of Official Use OnlyMassachusetts Permit No. BLDE 23-005113 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/N INK OR TYPE ALL INFORMATION) Date:3/17/2023 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) 11 WHIFFLETREE RD Owner or Tenant JEFF BURKE Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No 0 (Ch riate le, Purpose of Building Utility Authorization Existing Service Amps Volts Overhead 0 Undgrd s C New Service Amps Volts Overhead 0 Undgrd J _ e Number of Feeders and Ampacity ; Location and Nature of Proposed Electrical Work: Wiring for master bedroom, bath &HVAC. t////J p ' - vv Completion of the following table may be a y�h� Spector of Wires. No.of Recessed Luminaires 4 No.of Ceil.-Susp.(Paddle)Fans No.of off\ 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 8 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6 No.of Gas Burners 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 2 Total 2 No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 1 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: 1 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 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: JOHN C BURKE Licensee: John C Burke Signature LIC.NO.: 50364 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:45 DIX ROAD EXT,WOBURN MA 018016104 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 kv- .9/ ` -b se Commonwealth of Massachusetts rcq U Permit No.: l y r �_iir+=f t Department of Fire Services Occupancy and Fee Checked: i_ i [Rev. 12023 _t_l— BOARD OF FIRE PREVENTION REGULATIONS yam.='.`V APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 City or Town of: G,Jes VArr.rrw -'A Date: _c/i SA To the Inspector of Wires:By this application,the un gives notices of his or her intuition to perform the electri work described below. Location(Street&Number): /1 j// / / e t, Unit No.: Owner or Tenant: -a, ,n ire.._ Email: Owner's Address: Phone No.: C./2— >3 5' •-'//c Is this permit in conjunction with a building permit?(Check appropriate box)Yes'No❑Permit No.: Purpose of Building: 5;.Ns 1,- r,,, ;/ Utility Authorization No.: Existing Service: Amps / Volts Overhead El Underground❑ No.of Meters: New Service: Amps / Volts Overhead 0 Underground❑ No.of Meters: Description of Proposed Electrical Installation: sTe/y c9 y,.,i S-lit // (;t4 , , ,t,, -- ,L /)3/2c-41 2e dre.,),,n. l /34-'7// /- fine Completion of the following table may be waived by the Inspector of Wires. No.of Receptable Outlets: 8 No.of Switches: rD Generator KW Rating: Type: No.Luminaires: a No.of Recessed Luminaires: i-/ No.Wind Generators: Wind KW Rating: No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: No.Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices: Swimming Pool:In-Gmd.❑ Above-Gmd.❑ Hot-Tub❑ No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: ` Video System 0 No.of Devices: No.Air Conditioners: a Total Tons: ,�TV,4/ Telecom System❑ No.of Outlets: / No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: No.of Modules: Roof-Mount❑ Ground-Mount 0 Level 1 ❑ Level 2❑ Level 3❑ Rating: OTHER: Attach additional detail if desired or asequired by the Inspector of Wires Estimated Value of Electrical Work: d)000. of (When required by municipal policy) Date Work to Start: 3//3/b) 3 Inspections to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: / A-1 0 or C-1 0 LIC.No.: Master/Systems Licensee: LIC.No.: Journeyman Licensee: J Ni./ 13Jit/( LIC.No.: ,S'o 3 6 `7' Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: Address: ys D X o2o i) £Y 14 C41 U 6✓rvN) Pi A- O I ST % Email: 4 .,r, Ke y cit i rJ e 5/h 4./. U d n Telephone No.: 7fT/ —2 Er9 -/9 Wr I certi and- th, .,air ""enalties of perjury,that the information on this application is true and complete. License- �'�,,`��(, Print Name: :To 11rn/ .Z�,,./ Cell.No.: 7,-/—7 J,/�, INSU' • CO ' • GE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provid, ., of of liability including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force and has exhibited proof o the permit issuing office. CHECK ONE: INSURANCE BOND❑ OTHER El Specify: 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: Tel.No.: Signature: Email.: p s o 75 1