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Home My WebLink AboutBLDE-22-002893 - Commonwealth of Official Use Only V Massachusetts Permit No. BLDE-22-002893 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.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:11/18/2021 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) 14 SHANNON CT Owner or Tenant ROBERTS WILLIAM R Telephone No. ° Owner's Address ROBERTS ELIZABETH ANN M, 115 CHILSON RD, WILBRAHAM, MA 01095-12�� w ' Is this permit in conjunction with a building permit? Yes 0 No 0 (Chbc p op ttx* . Purpose of Building Utility Authorization No. *(37 \_ ,``) Existing Service Amps Volts Overhead 0 Undgrd 0 ..4 toly-- New Service Amps Volts Overhead 0 Undgrd 0 No.6t�Metihs -(- '.`-\ Number of Feeders and Ampacity r; Location and Nature of Proposed Electrical Work: Change meter, remodel kitchen, add lighting, dryer, &exterior lighting. Completion of the following table aived[by Ike Jxspector 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 Connection 0 Other: 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Richard J Haley Licensee: Richard J Haley Signature LIC.NO.: 11867 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 544,43 CONVERSE ST,PALMER MA 010691705 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: $250.00 email !AS tt-rel in eQ -1—L i C RECEIVED aa� yqA��i LAU __.__._..r--&-,-- -- C mmanweaUh of/rlaseachwette Official Use Only 93 �..n� L�.JZ/IjJ. :�1;,: t cc77 Stroked Permit No. � ;F. 2parimani al)ire Serviced ~e "5:�( Occupancy and Fee Checked a UILuir _,c'' ,..,.0•T iNT :OARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: g/pg 120 z t City or Town of: YARM O UTH To the InsjIector of Wires. r By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) of .S H4NMOA/ COv tt7 Owner or Tenant 46NN/5 ENO L Afaar Telephone No.eit i4)45.7*,.036 6 Owner's Address /2/ coat itun/ Adlt74 I vDLOGI /114f7�• n/el8-4 Is this permit in conjunction with a building permit? Yes ❑ No u[7 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existingcleil Service / �� Amps /ZO I ZgQVolts Overhead� Undgrd❑ No.of Meters ', New Service Oa Amps ,(pd /240 Volts Overhead TA," Undgrd❑ Na.of Meters J � Number of Feeders and Ampadty 2 4/60.Q �f.a r � Location and Nature of Propo Electrical ork: -/'/y S//A/ n✓ Ai. G Ice f L f+✓A/U(>n(t 074170 ANQ IQi/d.7�� Ovra-.p /4$r2/.(L /i/LN 17 Comp tenon ofthef lowm&table may be waive by the btspector Wires. il o.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers ICVA _ '-Ti Na.of Luminaire Outlets No.of Hot Tubs Generators KVA ,{ No.of Luminaires Swimming Pooi Above In- No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FiRE ALARMS INo.of Zones No.of Switches No.of Gas Burners -T'Io.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Iota! Tons 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 a Municipal (Omer Connection No.of Dryers Heating Appliances Kµ, Security Systems:* No.of No.of Water KW No.of No.of Data Wiringvices or Equivalent HeatSigns 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 f El ctrical Work: YOOU•.11 (When required by municipal policy) Work to Start Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE 0 ERAGE: 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/k BOND 0 OTHER 0 (Specify:) I certify,under the p ns a • en allies ofperjury,that the information on this application is true and complete. FiRM NAME: - Q. -aft .. _ i //VL LIC.NO.: Licensee: _ IL. _ SignaturVIyIldr _, j LIC.NO.://,74 74 (If applicable.enter"exempt"in lb, cense number line.) Address: :us.Tel.No..441.S'96-2£s6Iii Tel.No.: °Per M.G.L.c.147,s. security work requires Department of Public Safety"S"License: Alt 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)D owner []owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:S 0'5—v.Cep 7s±7S r/oo