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Home My WebLink AboutBLDE-23-004733 0 - - Commonwealth of Official Use Only _ Massachusetts Permit No. BLDE-23-004733 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:2/27/2023 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) 95 WILFIN RD Owner or Tenant BARRY JOHN Telephone No. Owner's Address BARRY MARY P, 8 WEDGEWOOD CT, NEWTOWN, CT 06470 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. f Existing Service Amps Volts Overhead 0 Undgrd 0 � no.o ar f/ New Service Amps Volts Overhead 0 Undgrd ❑// /�\;� bftlr i Number of Feeders and Ampacity • I Location and Nature of Proposed Electrical Work: Remodel livingroom, kitchen, bed room, &laundry. -(1'��, 4,"I C�/6 'X P ry I r J '''t/ r' 17 i � Com letion ofthe followingtable may p 1`�t�yy�l�Y'th,,e''fn�e�o'r of Wires. No.of Recessed Luminaires 6 No.of Ceil.-Susp.(Paddle)Fans No.of 'I f ,/ ^:-.,. otal Transformers ,,s,. VA No.of Luminaire Outlets No.of Hot Tubs Generators --o 1, VA No.of Luminaires Swimming Pool Above ❑ In- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 26 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 14 No.of Gas Burners No.of Detection and Initiative 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 5 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: 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: Lucas Goff Licensee: Lucas Goff Signature LIC.NO.: 10820 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 19 MARION AVE, MILLBURY MA 015274213 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 •IF - I /icE/ise %/2-1 -RECEIVED ern it/led FEB 2 PRarl n ealth of Massachusetts Permit No.: V — 7te 3 - -- ili , -_ De r ent of Fire Services Occupancy and Fee Checked: [1- ., '� ► AorIA: PREVENTION REGULATIONS [Rev. l/2023] '' " 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: YARMOUTH . Date: To the Inspf rtor of Wires:By this application,the undersigned gives otices of his or her intention to perform the electrical work described below. Location(Street&Number): 4� (,�i i I Z , ya Tic. a yU�Unit No.: Owner or Tenan4 jOktk, a rr� ary('ry Email: c Y�t'�,1 itd. ( ✓ C—C ' Owner's Address: R /� .5 C.c�� 1 1 n L.,�` Phone o.: /a�. � 8-,-/-5,3 Is this r.,rmi.in conjunctinn with a building permit?(Check appropriate box)Yes Par No❑Permit No.: LID —,.3 'o00 18' -- r pose o'building: Utility Authorization No.: Existing Service: Amps / Volts Overhead❑ Underground❑ No.of Meters: New Service: Amps / Volts Overhead❑ Underground❑ No.of Meters: . Description of Proposed Electrical Installation: L / v /6-1 S A ivr ,/.,' /14 ,--t l 0C",'( ' Completion of the following table may be waived by the Inspector of Wires. No.of Receptable Outlets: a No.of Switches: /y Generator KW Rating: Type: No.Luminaires: No.of Recessed Luminaires: /4,2 No.Wind Generators: Wind KW Rating: No.Appliances:,5 KW: No.Water Heaters: KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Tr'tal KW: No.Heat Pumps: Total KW: Total Tons: Fire Alarm System❑'No.of Devices: Swimming Pool:In-Grad.❑ Above-Grnd.0 Hot-Tub❑ No.of Self-Contained Detcction/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices: No.Air Conditioners: Total Tons: Telecom System 0 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 D Level I ❑ Level 2 0 Level 3❑ Rating: J OTHER: .. .. . .........._._...... ... ..... Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 310 a U _ (When required by municipal policy) Date Work to Start: SA)7. Inspections ctions to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: L ✓cv.,S 64r,r_ A-1 ❑ or C-1 ❑ LIC.No.. Master/Systems Licensee: LIC.No.: Journeyman Licensee: /03"Dr . l3 LIC.No.: Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: Address: rl 10 ` 1 c /-Lc J-..tr lid( K c' . Email: L ✓ V.t Q$'31'7Y 0yAlAc'G', ( U,M - Telephone No.: I certify,under the pains and penalties of perjury,that the information on this application is true and complete. Licensee: - �' / Print Name:_ i/,if 6a^r/^ Cell.No.: = `fg-/°/�',}' INSURANCE COVERAG Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force and has exhibited proof of s e to the permit issuing office. CHECK ONE: INSURANCE[BOND❑ OTHER❑ 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.: _. - - _ l'"`•416- :Pft 611111111111kaiiiii... „ • • • ._ • • . . • • • • _ __ _ -- . - 1 _