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HomeMy WebLinkAboutBLDE-22-004883 \\ Commonwealth of Official Use Only el. ,� Massachusetts Permit No. BLDE-22-004883 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ' JRev.1/071 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:3/4/2022 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) 9 PHEASANT COVE CIR _ Owner or Tenant MCCABE JOHN H Telephone No. L'' Owner's Address MCCABE LESLIE R,130 COOLIDGE RD,WORCESTER,MA 01602 sir—w Is this permit in conjunction with a building permit? Yes❑ No ❑ ( o.}`�,_• Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 o to 4 New Service Amps Volts Overhead 0 Undgrd 0 N Number F s and Proposed osed ( /„� O� Location and Nature of Proposed Electrical Work: Remodel kitchen �"/�V/''') Completion of the following table may tv ` sector of Wires. No.of Recessed Luminaires 8 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 R bove ❑ grnd CINo.of Emergency Lighting My! Battery Units No.of Receptacle Outlets 6 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 4 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 K55 No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal p Other: Connection No.of Dryers Heating Appliances KI\ Security Systems:* No.of Devices or Equivalent No.of Water , 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: Thomas E Cunningham Licensee: Thomas E Cunningham Signature LIC.NO.: 8410 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO Box 48,Leicester MA 015240048 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:S75.00 i rn1 it ein�zi1 ,i��Ft e RECEIVED• L � � 1 ►LIAR 03 2022 ' /� _commoruvea/h al MaeoachuJelle Official Use Only 4i G.DtPgRTMEN c7 'r• >a.:— iirparfan•nt o` }i�r srvic.e Permit No. �23 p BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked V [Rev. l/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Z kPLEASE All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 C R I .00 PRINT IN INK OR TYPE ALL INFORMATION) 3 City or Town of: Date: YARMOUTH To the Inspecto wires. U By this application the undersigned give otice of bis or hey jntention o perfo the ele rical work described below, Location(Street&Number) s,1 J (lc) ,j� / ,/ `� c� Owner or Tenant %��fy' ", S (_.(_ Owner's Address Telephone No. Is this permit In conjunctig 11 n with a building permit? Purpose of Building /- © N0 ❑ (Check Appropriate Box) v �� ) �(r/ � � 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 Ampaclty ��ii <- / ( -- ,J 2 i ��,r Location and Nature of Proposed Electrical Work � !5 � —�� kri .ir Com letion o the ollowin table m be waived b the Ins actor o Wires. 1.1. No.of Recessed Luminaires f--'; No.of Cell:Sasp.(Paddle)Fans °•o ota ev No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA - No.of Luminaires Swimming Pool ve ❑ n_ o.o mergency g in �` No.o[Receptacle Outlets rod. nd. Bette Units g (_ No.of OU Barnes FIRE ALARMS No.of Zones v. No,of Switches (_ No.of Gas Burners o,o etec on an It! No.of Ranges Initiatin Devices No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers eat ump um er oas Totals: o.o e outs ne No.of Dishwashers Detection/Alertin Devices Space/Area Hearing KW Local un c pa No.of Dryers Heating Appliances scor e Connection ❑ "lux o a er KW tY ystems: Heaters KW °•o 0 o No.of Devices or E uivalent Si ns Ballasts Data Wiring: No.of Devices or E uivalent No.Hydromasaage Bathtubs No.of Motors Total HP a ecommun ca ons r ng: OTHER: No.of Devices or E uivalent Estimated Value f E tri 1 a Attach additional detail if desired,or as required by die Inspector of Wires. Work to Start: )oo Q ork. (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERA E: Unless waived by the owner,no permit for the performance of electrical work mayissue the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. unless CHECK ONE: INSURANCE The � BOND ❑ OTHER 0 (Specify:) I certify,under the pairs and penalties o perjury,that the informado on th FIRM NAME: b' �- C S plieati ra is true and complete Licensee: I'L UGl / LIC.NO.: ��� (If applicable.enter exempt to the license Signature Address: "tom 'no LIC.NO.:LS E:,S! *Per M.G.L.c. 147,s.57-61,security work requires Departmentf S / Bus.Tel.No.•OWNER'SLic. No. INSURANCE WAIVER: of Public safety"S"License: Alt.Tel.No.: ice" T required by law. ByI am aware that the Licensee does not have the liability insurance overage normally Owner/Agent my signature below,I hereby waive this requirement. I am the(check one Signature owner • owner's a.ent. Telephone No. PERMIT FEE:$