The URL can be used to link to this page

Home My WebLink AboutBLDE-17-003877i a Commonwealth of OtlicialUse Only �® Massachusetts Permit No. BLDE-17-003877 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 ININK OR TYPEALL IVFORAUTION) Date:1/31/2017 City or Town of YARMOUTH To the Inspector of IVires: By this application the undersigned gives notice ot his or her intention o per orm we a ec ica work described below. Location (Street & Number) 53 LEVIS BAY BLVD Owner or Tenant DAMICO JOSEPH A TRS Telephone No. Owner's Address DAMICO ZABELLE G, PO BOX 41, HOLDEN, MA 01520-0041 Is this permit In conjunction with a building permit' Yes ❑ No ❑ (Check Appropriate Box t`n Purpose of Building Utility Authorization No. 1993: Existing Service 200 Amps Volts Overhead ❑ Undgrd ❑ No, of 1lleters New Service 200 Amps Volts Overhead ❑ Undgrd ❑ No. of Aleters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Relocate service from O/H to U/G. Completion of the followine table may be waived by the Inspector of IVires. No. of Recessed Luminaires No. of Cell: Susp.(Paddle) Fans No. of Total Transformers V No. of Luminaire Outlets No. of Ilot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ rnd. rnd. No. of Emergency Lighting 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 No. of Ranges No. of Air Cond. Total No, of Alerting Devices No. of Waste Disposers Ilest Pump Totals - umber ns ToKW No. of Self -Contained Detect lon/lertine Devices I No. of Dishwashers Space/Area Beating KW Local ❑ hlumclpal ❑ Other. Connection No. or Dryers IieatingAppliances KW Security Systems:* 0 of Devicei or Eaulystent No. of Water KW liesters No. of No. of Si ns allay Data Wiring: No. Devices or F, uival n No. Ilydromassage Bathtubs No. of Motors Total IIP Telecommunications IViring: 'o o es or F alen OTHER: Attach additional detail if desired, or as required by the Inspector of IVires. 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 ❑ BOND ❑ OTHER ❑ (Specify:) f certify, under the pains and penallies of perjury, that the information on this application Is true and complete. FIRM NAME: Paul J Petersen Licensee: Paul J Petersen Signature LIC. NO.: 14110 (Ifapplicable, enter "exempt" in the license number line.) Bus. Tel. No.: Address:155 QUAKER MEETINGHSE RD, EAST SANDWICH MA 025371311 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: 1 am aware that the License does not have the liability insurance coverage normally required by law. But signature below,) hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. S50.00 46- � — Mort �atSof�6— 41 %f `7 31��t- \v Ip � z w r� a cy w 0 Li V l�e,nrnormc6Clh of %%%waae�.�,eit`, ofs.R l Us—e o-ny .1JeparCmenE o�Ji+v JcrviceJ BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ev. 1/0'1] (leave blank) APPLICATION FOR PI=RMIT TO PERFORM ELECTRICAL WORK All work to be p!rforaied in accordant with the Massachmcrs Electrical Cod: WC). 527 CMR 1 Z00 (PLEASEPREJTINB�KORTYPEALLINFORM4YY0Aq Date:f3 /1:� City or Town of: YARMOUTH To the Inspector of Wires: By this application the t,mdermgned gives nonce of his or her intention to perform the electrical work descn bed below. Location (Street & Number) rj3 Lew 15 " 48601W arO Owner'orTenant J& P!Aw co Telephone No. Owner's Address 'PO i�&ic 41 RoWe l MA 01520 Is this permit in conjunction with a building permit? Purpose of Building_ Existing Service ZOO Amps 1'O / Z`A Volts New Service 200 Amps l20/ 2'ib Volts Number of Feeders and Ampacity 3 Uare_ p,W Location and Nature of Proposed Electrical Work Yes ❑ No D (Check Appropriate Box) Utility Authorization No. ag 33� Overhead � Undgrd ❑ No, of Meters Overhead ❑ Undgrd I rl Nti. of Meters No. of Recessed Luminaires win=ieacn or tree )ollawm- sable m_ be watved the Irtroector of Fiver. No. of Cei1 5usp. (Paddle) Farts o, of Total No, of Lumiaair_ Outlets No. of Hot Tubs Transformers KWA Generators KWA ' No. of Luminaires ISwimmfag Pool ove ❑ _ ❑ erred. erred. o. or met rency Q ang IEaLLry IInfts No. of Receptacle Outlets No, of Oil Burners FIRE ALARMS No, of Zones No, of Switches No, of Gas Burners o. of Detection and Initiatine Devices No. of Ranges sl No. of Air Cand. Tons No. of Alerting Devices No. of Waste Disposers eat mp umber Tons o. of elf ontarn Totals: Deteetion/Alertine Devices No. of Dishwashers Space/Area Heating KW' Local u * Q ❑ Other n Connection No. of Dryers Heating Appliances r Security ysteraw o, of ater No. of Devices or Equivalent KW ° Heaters °' ° °' Sins Ballasts Datallo. of Devices or E uivilent No. Hydromassage Bathtubs No, of Motors Total HP elecommunicatious inng: No. of De-ices or Equivalent OTHER Estimated Value of Electrical Wort` y"L1 "' " � "r a rcV` ;tea Cy ME inspector of Firer. 00. CO (When ter{aired by municipal policy.) Work to Start 1 30 3 Inspections to lot 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 tailess the licensee provides proof of liabiliy in including "completed operation" cov=ge or its substantial equivalent. The und=i gned certifies that such 3 coverage is in force, and has exhibited proof of same to the permit issuing office. E? CHECK ONE: INSURANCE tiuND ❑ OTHER ❑ (Specify:) ,a I cer*, under the gins and ppeaches of perjury; that the fnformadon on this application is true rued complete. FIRM NAME: l ,�, i u� �„� LIC. NO.: 14110 Licensee: POu l J . peke,,, SIgnahrre LIC NO: (IfaPPlicable enter "¢empt 'n the /ieerse mtmber line) Address-Bus. Tel. No.: -fir• f� . 24 M r f 1 P. SGndw 'eh M /. O'LS�i -- t. No Alt. Te: J `Per M.G.L. e. 147, s. 57-61, security work requires Department of Public Safety "S" License: Alt. LicNo. � Q OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage norm S required by law. By my signature below, I hereby waive this requirement I am the (check one ❑ owner Owner/Agent owner's a eat Signature Telephone No. PERMIT FEE. S