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Home My WebLink AboutBLDE-22-005633 Commonwealth of Official Use Only E",, Massachusetts Permit No. BLDE-22-005633 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:4/4/2022 City or Town of: YARMOUTH To the Inspector Wires: \ By this application the undersigned gives notice of his or her intention to perform the electrical work described below. ` ✓" ��' Location(Street&Number) 72 MAYFLOWER TERR 1 ' 'A'^e Owner or Tenant Matthew Clark Telephone No. Owner's Address < Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A p o riateBox) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 . f t `\ �) New Service Amps Volts Overhead 0 Undgrd 0 No,of e Number of Feeders and Ampacity P tY Location and Nature of Proposed Electrical Work: Remodel master bed room&bath 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 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 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 Siens 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: Alan R O'Reilly Licensee: Alan R O'Reilly Signature LIC.NO.: 51570 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 LENTELL ST, SANDWICH MA 025632116 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 QJ 4ZZ- RE E L D MAR 31E21 m waa� yyi m Caman .atth of rrladdarhafte O cial Use Only BUILDING 1::ii,,i, NT Se Permit No. .5�� '� _:1 �parfm�nt of Jim rvicre _ By ;I ?7. Occupancy and Fee Checked S BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) a APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M C),5Iz7 CMR 12.00 j (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 3 I lad City or Town of: YARMOUTH To the Inspe for 9f Wires: ,.By this application the undersigned gives notice of hisi or her intention to perform the electrical work described below. Locaton(Street&Number) 71a (An. -cIO,trct' YC(QLc. J Owner or Tenant IfAi_ . ,,y ( 1� L Telephone No. �'1H�9 ti 135'I Owner's Address 5,t,ti„e c.. r.1(N>y."‹... v Is this permit in conjunction with a building permit? 1 Yes No ❑ (Check Appropriate Box) Purpose of Building '(V�w s.im.c S v;•C r ' e l ke Utility Authorization No. O Existing Service Amps.......ti New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity i Location and Nature\of Proposed\ �E^lectrical Work: R wr • „L \ a_ V.-rsrL W � 'n� nA -t-\c�-a! r)�rpc,� ct}�. otv� Otte rtiS N'N Ctcj vi Completion of the following.table may be'valved by the Inspector of Wires. (!. No.of Recessed Luminaires No.of Ceil:Sas No.of 7 otal p.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA d- No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting Arad. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and - Initiating Devices 11' No.of Ranges No.of Air Cond. Tool No.of Alerting Devices No.of Waste Disposers Heat Pump Number Toms W "No.of Self-Contained - Totals:I .......... _.....L fK... ........ .. Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑Municipal ❑Omer Connection No.of Dryers Heating Appliances KW Security Syystems:• No.of No.of Water KW No.of No.of Data Wirinevices or Equivalent Heaters Signs Ballasts 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 lectr'cal Work: (When required by municipal policy.) Work to Start: ,� >l 02 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO E 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 a permit issu office.g oce. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) "TrgJ �c.lS, 1).9. -• I certify,under the painsand pena ties per ury,that the Information on this application is true a,Id complete. FIRM NAME: a (. M,Ir r. u ti LIC.NO.: Licensee: •` Signature g LIC.l. o.'NO �S S`7 (If applicable,a er"exempt"in the license nu ber lr // / Bus.TeL No.. �7 Address: )' Le,,, c]' _ Na,a-jt...li C0. Alt.Tel.No.: �Stt$)Ei..j Sj-y d. 1•Per M.G.L.c.147,s.57-61,security work requires Department Public Safety" License: Lie.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 ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:S