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Home My WebLink AboutBLDE-23-003375 - --- Commonwealth of Official Use Only I Massachusetts Permit No. BLDE-23-003375 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:12/19/2022 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 electncal work described below. Location(Street&Number) 27 PAR 3 DR Owner or Tenant ROCK DIANE B TR Telephone No. Owner's Address D B ROCK REV LVG TRUST,27 PAR 3 DR,SOUTH YARMOUTH,MA 02664-2129 Is this permit in conjunction with a building permit? Yes❑ 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: Wire 10-cir manual generator switch and AC. 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. );rnd. 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. Tonal No.of Alerting Devices 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 ❑ 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:) /certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: DANIEL P DONNELLY Licensee: Daniel P Donnelly Signature LIC.NO.: 50906 (If applicable,enter"exempt'in the license number line.) Bus.Tel.No.: Address:PO BOX 137,HARWICH MA 026450137 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 Ole_ ��IN.4L /2/.Q/3 ,. '-=*___ , Comr sonwea of Ma..dsac a • - Official Use Only i�t=-t cc--�� Peit L' '/ 'jrscrvecti • 'f Occupancy and Fee Checked Y-,,,--;�.•� BOARD OF FIRE PREVENTION REGULATIONS Rev. I/07] (leave blank) NOP APPLICATION FOR- PERMIT TO PERFORM All work to be performed in accordance with the Massachusetts ELECTRICAL WORK Electrical Code (MEC), 527 CMR I2.00 (PLEASE PRINT IN INK OR TYPE ALL INFO]M4 TION) Date: _4 0- City or Town of: 4,D—iq YAR,VIOUTH To the Inspector of Wires: . By this application the pndersigned gives notice of 's or her intention to perform the electrical work described below. Location (Street & Number) • l Owner or Tenant IAA-00 e • C1?' C Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing ServicaCe Amps /a)Oi olts Overhead � Undgrd ❑ No. of Mete rs / New Service Amps / Volts Overhead ❑ Undgrd g ❑ No. of Meters Number of Feeders and Ampacity Location and,Na a of roposed lectrical Work: leh /6 -p lv CI- ( .-- Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceii.-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 rnd. mid. {Battery Units No. of Receptacle Outlets 1 p No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices Total No. of Ranges 1No. of Air Cond. Tons No. of Alerting Devices No. of Wa Heat PumpI Numbe ste Disposers r.. Tons -.� KW_ No, of Self-ContainTotals: _ ed 1Detection/Alerting Devices oth A No. of Dishwashers Space/Area Heating KW' Local ❑ Municipal ❑ � Connection_ No. of Dryers Heating Appliances KW Security Syystems:* - - -� No. of WaterNo. 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 Wiring: No. of Devices or Equivalent OTHER: Attach additional detail V'desired or as required b the Ins ecto I Estimated Value of EIectrical Work: (When required by municipal policy.) y P r of Wires. Al Work to Start: /,)./C-0)a Inspections to be requested in accordance with MEC Rule 10, an INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electricald upon completion.e the licensee provides proof of liability insurance including "completed operation" coverage or its substantial work may issue unless undersigned certifies that such coverage is in force, and has exhibited proof of same to thepermit issuinequivalent, The O CHECK ONE: INSURANCE f 23 BOND ❑ OTHER g office. I certify, under th�pQ' and penalties o er'u that0 (Specify:) f ry, the information on this application is true and complete FIRM NAME: � / CZ`) Y LIC. NO.: t1 Licensee: Signature IC. NO.: (If applicable, enter "exe t" in t ' ense umbe li e.) Address: s. Tel. No.: *Per M.G.L. c. 147, s. 57-6I , security work requires Department of Pub �c Safety "S" License; It. Tel. No.: *%T I ,-cl/P7 ,� OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilityin Lin. No. 5 required by law. By my signature below, I hereby waive this requirement. I am the (check one surance coverage normally � Owner/Agent } ❑ owner El owner's anent, Signature. Telephone No. • PERMIT FEE: $