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Home My WebLink AboutBLDE-23-002981 co Commonwealth of Official Use Only krt.. Massachusetts Permit No. BLDE-23-002981 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:12/1/2022 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) 17 BLACK DUCK LN Owner or Tenant MALZONE LOUIS F Telephonet i„../ :::),th Owner's Address 67 UNCLE BARNEYS RD,WEST DENNIS, MA 02670 1 6 7 Is this permit in conjunction with a building permit? Yes 0 No 0 t '.141/ Purpose of Building Utility Authorization Nod Existing Service Amps Volts Overhead 0 Undgrd 0 o New Service Amps Volts Overhead 0 Undgrd 0 No.of r 4.,-,r) Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Permitting for room that was finished without permit or inspections. 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 8 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 ❑ 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: Bruce M Cofske Licensee: Bruce M Cofske Signature LIC.NO.: 11963 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 112 COHASSET ST,WORCESTER MA 016043241 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:1 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: $300.00 f. IKt: CtIVED 'R-eCt CiU NOV 3 0 2022 BUILDING DEPARTMENT Bv t1 ____—,_ Commonwsatth o{ aeea hu4.(Ee Official Use Onl 75 tBi ; � , Permit No k „�, �LJsPartnunf onirs �srvicse '''i'I ' BOARD OF FIRE PREVENTION REGULATIONS , -- ---;25 7 i AgOrl I Rev.1/07cy and Fee Checked '�'�� leave blank _ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /C k 20 Z City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perf rm the electrical work described below. Location (Street & Number) / 7 8 1 c:t_�K D k L, c c,..ti.,- _ C,( )e -� � �r . Owner or Tenant V`f' � G M C`� a r;i..a� Telephone N . / cj Z I (G q Owner's Address r Is this permit in conjunction with a building permit? Yes Cl/ No n (Check Appropriate Box) Purpose of Building Utility Authorization No. fExisting Service c" Amps i 2L, / c' 4 CVolts Overhead ❑ Undgrd No. of Meters New Service Amps / Volts Overhead E Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Propos Electrical Work: ' , S c 1+-8) S 1 W(�`�!_ !�'�S !S ..v D ••. { t? -c,.....- ,_.... Vw Completion of the followingtable may be waived by the Inspector of Wires. ti No. of Recessed Luminaires No.of Ceil:Susp. (Paddle) Fans No. of 'Total Transformers KVA �1 No. of Luminaire Outlets No. of Hot Tubs Generators KVA C.\ rt.. No. of Luminaires Swimming Pool Above ❑ In- ❑ 'No. of Emergency Lighting grnd. grnd. Battery Units �y No. of Receptacle Outlets -j No. of Oil Burners FIRE ALARMS INo. of Zones "- No. of Switches No. of Gas Burners No. o>'Detection and �, Initiating Devices . i 1' No. of Ranges No. of Air Cond. TonsTota No. of Alerting Devices 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 ❑ uM nicipal ❑ Other Connection -i No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water Heaters KW No. of No. of Data Wiring: Sins Ballasts g No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wirin : No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value o El trical Wo , / 7�C' (When required by municipal policy.) Work to Start: 1. C, ci 2 2 In pections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE VERAGE: Unless waived by the ow.acr, 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:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. / � FIRM NAME: 6,, c. C,-, 5 � i c ,` CU.Ltc-k....i-0/----- LIC. NO.: l J 9 6 3 - 1, Licensee: b L) c c,.._ �'GrS 1 /Signature „LG LIC. NO.: )1, y (p - 6 (If applicable, utter '.qxem t"in the license number line.? Bus. Tel. No.: `Y/S ' 13 - S?2 Address: t C 6 cx C,0 7 E . (,Uo,,,-e-t 1 Iv ,I> c 253 Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" 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. PERMIT FEE: $ 0 C 's