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Home My WebLink AboutBLDE-23-004049 _d Commonwealth of Official Use Only �E` Permit No. BLDE-23-004049 .,)) Massachusetts 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:1/23/2023 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) 3 CLIFFORD ST Owner or Tenant ANDERSON PRISCILLA M TR Telephone No. Owner's Address PRISCILLA M ANDERSON INV TRST, 142 LONG POND DR, SOUTH YARMOUTH, MA 02664 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: Wiring for new den area. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 1 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 7 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. ,TI,°Onal 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 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 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: WILLIAM A TRACIA Licensee: William A Tracia Signature LIC.NO.: 15005 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:68 DERBY RD,P.O.BOX 219,BERLIN MA 015030219 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 N?, / (/z r ( 2 / U--/N) pmat2'/ i kg • RECEIVED y — qq r _ _ iY.Omnrtna•en ih ri Vlnuorhnaelll tiffirird the only JAN 23 2QZ3fM �1 5' hermit No 13 O(-�_ • r e me I JUV- IM•1,e1 I Occupancy and Fee Checked , s OARDROCARREFIE NTION REGULATIONS !Rev.inn) 0,,,,„1,1,,nk) -_ By— — APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All wort to he ptttmrwd in nevoid:Ince unit tlr.blassavhnsdt.I les meal Cade(MFCI.527('MR 12(Ht (PLEASE PRINT 1N INK OR 17TF.ALL 1NFORMATIONI Dole: I-Z3-t3 City or Town of: vj,q.w •it, lit the Inspector of Wires: By this application the undersigned gives notice of his of her intention to perform the electrical work described below Location(Street&Number) a C I:((°`' r3r-)-' Owner or Tenant f T K-.t 1„ nn,1,%S n v -- - Telephone No. Owner's Address ��'l Is this permit in conjunction with a building permit'? Yes L No ❑ (('heck Appropriate Boa) Purpose of Building Residential Utility Authori,ation No. - Eaisting Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Senior Amps / Volts Overhead❑ Undgrd❑ No.of Meters ___ Number of Feeders Hod Ampacity Location and Nature of Proposed Electrical Work: l. ce era-' 0[•v ‘k.e Completion of the following table mar he waived by the Ian of Wins Total No.of Recessed Luminaires t No.of Ceil-Susp.(Paddle)Fans TNransformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators K%A No.of Luminaires SwimmingPool Atone ❑ In- ❑ No.of tmergencv Lm,hung _grnd. grnd. Battery Units No.of Receptacle Outlets "7 No.of Oil Burners FIRE ALARMS No.of Zones f ection and No.of Switches I No.of Gas Burners No Ini�tingDV! es TNo.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Totals: Pump Number Tons,,. KW No.of Stir-Contained Totals: I Z Z _ Detection/Akrtio Des ices No.of Dishwashers Space/Area Heating KW Local❑Monnectionnceett n ❑Otter C Nu.of Dryers Heating Appliances KW Security Systems:' No.of Devices or Equivakat No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No,of Devices or E uisalent No.Hydromassage Bathtubs No.of Motors Total 11P Telecommunications-Wiring: No.of Iles ices or EQuisaknt OTHER: Attach adrhl iunal thrall lfdrsbrrl ear to r<ymrs.i by the Insp.-tor of lives. Estimated Value of Electrical Work: Z Z"To (When required by municipal policy.) Work to Start: I L 3 23 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner.no permit for uhc performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation•coverage or its substantial(qui%alent. Thc undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE® BOND D OTHER❑ (Specify:) 1 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME:Bill Tracia Electrical Contracting,LLC LIC.NO.:A15005 Licensee: Bill Tracia Signature '— LIC.NO.: (ifupplicuble,,enter"'amp"in the license.mambo-line) Bus.TeL Na•50&612-2244 Address: PO Box 219,Berlin,MA 01503 AIL TeL No.: °Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee elites not harts the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:S I gra CatnScanner