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Home My WebLink AboutBLDE-23-001459 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-001459 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:9/19/2022 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.: _ O Location(Street&Number) 37 DAUPHINE DR i3 C7. Owner or Tenant Fitzpatrick Telephone No. Owner's Address 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 ❑ 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: Boiler replacement. Replace receptacle with GFCI. 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 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 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/Alertine 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: JESSE R LING Licensee: Jesse R Ling Signature LIC.NO.: 15646 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 1200,WEST CHATHAM MA 026691200 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: $50.00 C7,17 / /� nn,, _ C_.ommonweeza 6,14 Fa66ac�ett6 Official Use Only -- __ ,.=_ — c� �7 7 / bit.5 7 Permit Now�7 ' i-= _-...i7 aL1 artment olIire Services c. ='e_l Occupancy and Fee Checked �_ =i= BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) i 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 I17 INK OR TYPE ALL INFORMATION) Date: ci,. —IA ,--2-` City or Town of: Y-INP:ftir .K 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) . '�� 7 O rar V iD N t'14.- 0�'- Owner or Tenant 1--\ `Y Z 1' rN�~-_\C _ _ Telephone No. Owner's Address 3 )F L%:-‘-'' \,- ' - --"\:`V Is this permit in conjunction with a building permit? Yes No la (Check Appropriate Box) Purpose of Building -0 UD I k-(_. Utility Authorization No. Existing Service Ir,:^C Amps 1 v /"),`C'Volts Overhead NQ Undgrd 7 No.of Meters 1 New Service Amps / Volts Overhead Undgrd No.of Meters Number of Feeders and Ampacity # Location and Nature of Proposed Electrical Work: '6 0 ,`Q 0.... 12Q =,0, 1` `-(_ t '-'--' k --17`L. 4.a (. �-► t ,C. ` t L .C' L.):. C� t: 7. Completion of the following table may be waived by the Inspector of Wires. No.of Cel Bur (Paddle)ners FIRE AL----ARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners , Initiating Devices No.of Ranges No.of Air Cond. `- Tom No.of Alerting Devices Heat Pump Number Jobs_=:.iW — No.of Self-Contained tin No.of Waste Disposers Totals: 1,,.-- _ Detection/Alerg Devices _ ,.-- No.of Dishwashers Space/Area Heating KW ❑ Municipal Connection ❑ � Heating Appliances KW LSecurity ems:* No.of Dryers No.of De or Equivalent No.of Water , No.of No.of Data Wiring: .�` Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP I No.of Devices or Equivalent OIH R: c o Attach additional detail if desire4 or as required by the Inspector of Wires. Estimated Value of Electrical Work: i (..13° (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 ❑ OTHER ❑ (Specify:) I certify,under the pains andpennitiPs of perjury,that the informatipn on this application is true and complete. FIRM NAME: ,.-.A i-ti.( 1,Q(.--C\.O tAst N CA t LIC.NO.: kl.SCo 410 Licensee: -ad_ �_ 1.. ,t 1.C.G Signature . � Li LIC.NO.: -e3 t7°.34 (If applicable enter "exempt"in the license number line.) - Bus.TeL No.: Address: 3 O C2.0e t,IJ -Clckill t+/.0-11 lbc da,-0 Alt.Tel.No.: Sob-4 - *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)❑owner ❑owner's agent. Owner/Agent o Signature Telephone No. PERMIT PE: $ .$c