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Home My WebLink AboutBLDE-23-004633 or Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-004633 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:2/22/2023 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) 10 CLIFFORD ST Owner or Tenant O'PACKI PETER F JR Telephone No. Owner's Address O'PACKI PATRICIA, 50 BELLVISTA RD, WORCESTER, MA 01682 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 ❑ o.of Meters New Service Amps Volts Overhead 0 Undgrd 0 o f Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: First floor bathroom. An Completion of the followin l w,P1 {� ector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of O �l/Jotal Transformers ��/// (f KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting O 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 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: Michael J Chase Licensee: Michael J Chase Signature LIC.NO.: 20654 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 19 MAYFAIR RD, SOUTH DENNIS MA 026602903 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: $75.00 ! RECEIVED [ FEBL2 -- Camma,1a aQ 01 n7a lu.0.e� 7 Official Uses Only 1 a -1 Permit No.2 L3"' ( LD9 BUIING25• '" -7��wk" By T Occupancy and Fee Checked -- :OARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) 13 ... APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK �/(All work to be performed in accordance with the Massachusetts Electricall Code(MhhhEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /2-03.3 City or Town of: Ytvz+"s a 4'H' To the Inspector of Wires: By this application the undersigned gives notice of his or leer intentiionn to performer the electrical work described below. Location(Street&Number) JO -j i fin---s 1 S/aeeor p Owner or Tenant 1 kr- 6'I"A G-K-1 Telephone No..� 3 e' I`f- s-7d-I i Owner's Address !d a Oi�� $ ytp/c ,� .- / > - ,I,‘4.q Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) 4) Purpose of Building ge/4-44 vL-" Utility Authorization No. 2 ( Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters '4' New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters S(\` Number of Feeders and Ampadty p V Location and Nature of Proposed Electrical Work: Lsr &frn " -f i '-. o _ •f- H Completion of the followingtable may be waived by the Inspector of Wires. oad Uf No.of Recessed Luminaires No.of Cdl.s (Paddle)Fans No.oof TVA O5P• Transformers KVA C Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting ' No.of Luminaires Swimming Pool grad. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones T No.of Switches No.of Gas Burners No of Detection and FInitiatingg Devices IQ No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 'heat Pump Number.Tons. KW_ No.of Self-Contained No.of Waste Disposers Totals: Detection/AlertingalDevices Mu No.of Dishwashers Space/Area Heating KW Local 0 Cnnnicip eMion 0 Other No.of Dryers HeatingSecurity y stems:* Appliances KW 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 TelecommunicationsNo.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 -BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the inforaradon on dds application it true and complete.FIRM NAME: GHhsE Ut.EGTRGc. Gd G- LIC.NO.: /N 5-MI Licensee: F771aJgr-L C�/SE Signature 7t -- ' — L1C.NO.:a-64 (If applicable,enter"exem�jpt•"in the liticenscrnpnberiine / �.I Bus.Tel.No.' T��Zol( Address: P_U- L o'- I fT I 3 �riJ �� 6Rv—lt�l ( AIt Te4No. O "'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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:S . . t• 1 • fri • • • • • . . . • • • --