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Home My WebLink AboutBLDE-23-004171 Commonwealth of Official Use Only ra0 Massachusetts Permit No. BLDE-23-004171 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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:1/27/2023 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 electncal 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 ❑ 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"ROOM". 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 6 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. 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:" No.of Devices or Eauivalent No.of Water KW No.of Na.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total III' Telecommunications Wiring: No.of Devices or Eauivalent 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 SignaturePP Telephone No. PERMIT FEE:$75.00 -0 4)e /4b) CI ZP (q:3 00 official Use Only Commonwealg of fRamaclxuaet - 1 ik W. __ , c C� Permit No. � ' c---A o/2ire )ervice4 r: - _R + Occupancy and Fee Checked ii BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1�'07jii ..,, (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code MEC), 5 7 CMR 12.00 (PLEASE;PRINT IN INK OR TYP ALL INFO i�L4TION) Date: ` �- 3 (9a City or Town of: aft)/ 1 o the his eclvt' of Wires: By this application the undersigned rives no ce of his o her intention to perform the electrical work described below. Location (Street & i umber) �r Owner or Tenant y_ lig , i /.' �� ,' / c/,� Telephone No.�`7 a/a Owner's Address liverga MOW IL./e/ Is this permit in conjunction with a building permit'? Yes igi No I I (Check Appropriate Box) Purpose of Building Residential Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / _Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wire „ay?) Completion of the,following table muv he waived by the Inspector of fires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of TVA Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ in- ❑ No. ol Emergency Lighting grnd. 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 4Initiating Devices Ranges No. of Air Cond. Total No. of Ran g Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW No. of Self-Contained Totals: 1 �A o ) Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW... ElI Local Municipal ❑ � , Connection 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 Wirinu: No. of Devices or Equivalent OTHER: G-61) Attach additional detail if clesired or as required by the Inspector c f��i zres. Estimated Value of Electrical Work: j (When required by municipal policy.) Work to Start: 1 e3 �3 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C \ GE: 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 ❑ OTHER ❑ (Specify:) I 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 L/ ' �� LIC. NO.: (I/applicable, en/er "exempt in the license number line.) Bus. Tel. No.:508-612-2244 Address: PO Box 219, Berlin, MA 01503 Alt. 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: I am aware that the Licensee does no! hcn'e the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. T am the (check one) El owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 7.' C a mat l • coL, 1