The URL can be used to link to this page

Home My WebLink AboutBLDE-23-003903 Commonwealth of Official Use Only I—ar--:;\ Massachusetts Permit No. BLDE-23-003903 •-' 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:1/18/2023 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) 481 BUCK ISLAND RD UNIT 7C 7 1) Owner or Tenant SUSAN EATON Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) ( 7y Purpose of Building Utility Authorization No. v 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: Replace exhaust fan on 2nd floor&replaced two fixtures. 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- ElNo.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 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 Eauivalent 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: Michael J Suckow Licensee: Michael J Suckow Signature LIC.NO.: 32459 (if applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 162 MOUNTAIN AVE, PEMBROKE MA 023592647 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 Nip- l//i (q!Lc44 L/N' C l I a,k) l9 5' �23 (t,' �0 '14 l S/Zi fc fir triJ) �_- NN 1,6,4 I ' Commonevsalg 0/ Official Use Only J AN ' - c�r� n Permit No. -E2-3 -D 9 •�l , f parfmanf o f gips SeL.BU'LD 4 NT Occupancy and Fee Checked LI •ARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) (leave blank) BY•------ 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: I )2 22 1 ) City or Town of: )(XI( r)( 0 u' 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) q -R uc k: is (,t n(t. K A E3k,say)Owner or Tenant ) Eats Telephone No. -77y - 14 kl- 7 7q2._ Owner's Address q U �►�UC,i - 11« n c\ !''C. (_1 ru .1- 1 D Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building kJt6 cA I Utility Authorization No. Existing Service /'U Amps 170 I Volts Overhead ❑ Undgrd El No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: f e fad F�L i> p° l _ � l� 1 J ( �►LoLf1 s t° /C/7� i `')AI)A, �! n l,Y) _ t./L:7) 71 l�// fi 1' f' l c kii Completion of the followin&table may be waived by the Inspector of Wires. r No. U) No. of Recessed Luminaires No. of CHI.-Snap. (Paddle) Fans Transformers KVA allo. of Luminaire Outlets _ ;' No. of Hot Tubs Generators KVA vt No. of Luminaires Swimming Pool Above In- No. of Emergency Lighting g grnd. ❑ grnd. ❑ Battery Units No. of Receptacle Outlets L,, No. of Oil Burners FIRE ALARMS No. of Zones ut No. of Switches No. of Gas Burners 'No. of Detection and Initiating Devices II! No. of Ranges No. of Air Cond. Total No. of AlertingDevices 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 ❑ Munnneicictpalion ❑ other Co No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water , No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail f desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 02066 (When required by municipal policy.) Work to Start: 1 ' '%1 ° Inspections 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-c4 BOND 0 OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the Information on this application is true and complete. FIRM NAME: I,A ;r1 Ap I Si, l'._E Vv, LIC. NO.: 3 Z �c-i E Licensee:' L(\1�.,' ocY G w Signature LIC. NO.: 5 (If applicable, nter empt in the license number line �- Bus. Tel. No.:.�_3(-) - (I -3J -- Address: 1 L o o WCri(1,1() lv✓Y) t t-P eo �ti 1\ Q L `� Alt. Tel No.: tl/o'7 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 ay.are 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: $ —