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Home My WebLink AboutBLDE-23-002431 Commonwealth of Official Use Only , E` i' Massachusetts Permit No. BLDE-23-002431 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:11/2/2022 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) 5 RHINE RD Owner or Tenant MCKENNA PAUL A Telephone No. Owner's Address 5 RHINE RD,YARMOUTH PORT, MA 02675-2464 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Customer replaced receptacle (wired wrong)connect dishwasher properly&install required arc fault circuit breakers. 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 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 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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: $200.00 (2-11-2;z-' e 1 �= �+ Cc 11P6-Al -x p ,, r-tl14iT-- Boa. (ci RECEIVED L NOV 02 202t, Co,—.,,,,a/g al Mae6achase� Official Use Only 22 "'k,tt, '� c7 nn Permit No. (Z3 2-J( DE'(.._:y,,.V;lj eloarinunl of Jiro Jiwiced BUILDING --` I I—'. Occupancy and Fee Checked 7\ ' BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (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: //`...2 - .2 2 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) Owner or Tenant PP'/•< / )7/ r Ale, 2.-i.vGl2 Telephone No. iOwner's Address /',, e i4 Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service /Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters F Number o s and Proposed n 1� Location and Nature of Proposed Electrical Work: �A�,- _� ��e 7c- c� XLI dflt"'�.,'1„!�' /, •. es-- (`/� Atli Completion of the following table may be waived by the InNo.of sctor of Wires. U.) No.of Recessed Luminaires No.of Cell:Sam.(Paddle)Fans Transformers KVA CZt No.of Luminaire Outlets No.of Hot Tubs Generators KVA CA t• No.of Luminaires Swlmmtng Pool Above ❑ In- No.of Emergency Lighting yrnd. lrnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of Detection and No.of Switches No.of Gas Burners -No.Initiating Devices t' No.of Ranges No.of Mr Cond. Tool No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons_ KW 'No.of Self-Contained - Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW "cal❑M Counicipalnnection ❑°tiler No.of Dryers Heating Appliances KW `Security Systems:* No.of Devices or Equivalent No.of Water KW 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 if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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 0 BOND ❑ OTHER❑ (Specify:) I certify,under the pains pens ties of tie ry,that the information on this application is true and complete�.! FIRM NAME: 2-�ru.P - LIC.NO.:7S 7a96 Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.. Address: 'Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lie'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 / :;; f �elephone No. I PERMIT FEE:$o (�� .L