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Home My WebLink AboutBLDE-23-000557 • --� monwealth of OffcialUse Only '"LA F�1 , �� ssachusetts Permit No. BLDE-23-000557 �t)BDARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.1/071 yr 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:8/3/2022 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) 123 RUN POND RD Owner or Tenant JOSEPH AGRILLO Telephone No. Owner's Address 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: Remodel kitchen&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- ❑ No.of Emergency Lighting grad. 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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices To No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained Totals: Detection/Alertine 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 Sinns No.of Devices or Equivalent No.Hydrnnrassagc 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. p/ �( CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) gbgi {t76-L7 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: BRIAN R HICKS Licensee: Brian R Hicks • Signature LIC.NO.: 16881 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:19 COOLIDGE ST,SEEKONK MA 027714903 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,1 hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 /' '7.3, 1412-.1 C,142r--7/ 64) cPL1 C/l W23 4 E Nt - • R E C E I V E ''� �/' UG 0 2 2022 Co nwsa// of�Jaeeachuestte / OfficialU Use Only dlly F 761N. '•7 • •.nYd J Permit No. 2 3 L/�.7 J �/G 17tPARTMENT u� �rv�cseOecu anc and Fee Checked }t .'�.,i B�OARII.�E_RIREPREVENTION REGULATIONS [Rev. 1/07] y (leave blank) 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: (t< c ) — 02 2- City or Town of: YARMOUTH To the Inspector of Wires: c0 ft. By this application the undersigned gives notice of his or her intention to perform the electrical work described below. �/ J,i ,J , i Location (Street& Number) / 3 /?t.;ic' 0 (�� S t tf`. yp4/_./� tLl "1 `�i'l"+ Owner or Tenant �6S.:_ 1- i1 A AC1For,/ l L . 'j I? Telephone No. 1 Owner's Address Is this permit in conjunction with a building permit? Yes g No ❑ (Check Appropriate Box) L3L i) 23 • i Purpose of Building Utility Authorization No. COO /79 ....0 Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters (-- New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters IN Number of Feeders and Ampacity rr Location and Nature of Proposed Electrical Work: K ;tc- v i) � e,z_IL O lit tat '. 0-; 12 L l c- . -Ne_t.-J 1 '.C SS 1,(or` kt-i t tv ji:i.-f—div") -4N i_t t Vti jLe21 Completion of the following table may be waived by the In"ector of Wires, "Wo. of T ilk No. of Recessed Luminaires No.of Ceil.-Soap. (Paddle) Fans Total 0/ Transformers KVA 1n No. of Luminaire Outlets No. of Hot Tubs Generators KVA mot No. of Luminaires • Swimming pool Above ❑ In- ❑ No.of Emergency Lighting �rnd. grnd. Battery Units ':-) No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS INo. of Zones - No. of Switches No. of Gas BurnersNo. of Detection and i;t — _ Initiating Devices `i'�o. of Ranges No. oIAir Cond. Tons 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 ❑ Co nicipalnnection ❑ Other Co No. of Dryers Heating Appliances KW Security Systems:* '� No. of Water No. of Devices or Equivalent Heaters KW No. of No.of Data Wiring: Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications V�irfng: No.of Devices or Equivalent OTHER: Estimated Value of Electrical Work:*47M5' ere Attach additional detail if desired, or as required by the Inspector of Wires. (When required by municipal policy.) Work to Start: (- y - 029- 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 electriciii 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 rEf BOND ❑ OTHER 0 (Specify:) I certify, under the pains and penalties of penury, that the Information on this application is true and complete. ( FIRM NAME: & 14 ' /< L 12`r C ( 5'rl i i Le S- j N L LIC. NO.: �' 1 Licensee: e2 i ArJ 6We--_.1- Signature b LIC. NO.: (If applicable, enter "exempt"in the license number line.) Na.: Address: Bus. Tel. ��'- �5 .-��O Tel No *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Alt.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. I PERMIT FEE: $ I • - .1