The URL can be used to link to this page

Home My WebLink AboutBLDE-16-000663 Commonwealth of OfficialUseOnly �a< JE•.RI�� Massachusetts Permit No. BLDE-19-000663 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:8/1/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice Cl his or her intention to perform the electrical work described below. Location(Street&Number) 7 ANASTASIA RD Owner or Tenant QUINTILIANI EVELYN R TR Telephone No. Owner's Address QUINTILIANI INVESTMENT TRUST, 10 ROCKLAND ST, NEWTON,MA 02158-1411 Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Meter, New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Water heater in basement. 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 ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:' No.of Devices or Equivalent No.of Water 1 KW No.of No.of Data Wiring: Heaters Slung 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 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Gary L Gordon Licensee: Gary L Gordon Signature LIC.NO.: 15290 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:37 BILLINGSGATE DR,DENNIS MA 026382234 Alt.TeL No.: *Per M.G.L.c. 147,s.57-61,secunty 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 signature below,I hereby waive this requirement.I am the(check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 anuryeo erg of// 444...-ht, _ Ute C)yy y := Q • r- r7 / '•PenritNo, A`nl- Zeprr•t..rr nt v .7-in:S'crvi_-c BOARD OF FIRE PREVENTION REGULATIONS Ory Fee Chested �eP 1N7j (leave bleat) "--- _ Afl IVAPPLICATION FORIPERMET TO PERFORM ELECTRICAL WORK All work to be performed in emu,Scucc with the Messachvseos Electrical Code(MEC),:27 CMR 12.00 (PLF.ASEPRINT DIINK OR TYPE ALL NFORM4i7079 Date: City or Town on Y � MOg To the Inspector eJpi'ir By y this application the pnderapoed,foes notice of his or bar intention to pafo.tn the electrical wort described below. Location (Sweet&Number) a D C .moi. 0 A ' _4. 9 d / • OwnerorTenant 7e p, s,; q rgr < - 6 Telephone No. Oer s Address �� wn Isthis permit mconjuacrion ab • v�,�m'tv 7' Yes ❑ Ho p, (CheckApproprist:Bar) ' Purpose of Bolam° c�W,.P IItJiiy.4uthorization No. Efirdag Servtcea Amps Z2,9C Volts Overlies. I► Und;rd❑ No. of MetEr s New Se vice t `'- Amps I Volts Overheads Dndgrdo. of Meters u Nmbs of Fcders and Anxpacty fflA'A4f r ,��/�/�/,�/p Location and Nature of , nosed El- Wq • �� a- ' ` �L . s / J Comp)-$nn of the joffiwble table may be wcved by their-vector of rwer. No. of Remind d r.r,heir 'No.of Coll.-Rasp.(Pedd]e)Fans INTraasfo.of Total ormets 1;'VA No. ofL *oi _Omelet INo.'0fEotTabs IG_t rs • b'VA ' .6 - No_ofLto"++rn ISw nm ng Pool ?�vve ID- a 1Vn oihar�-�cpl ,vaag _ arced. ID-cl. El IEt41:7IIaiis No. of Rte-p{$�e OII..t IND.of Ott Earams 4L_APhIS INa.of Zones No. of Switches IN o.of D:;.ecnva and r_- _.--' —• No.of Gas Eners IairiatnL Devices ,] No.of Rs.ages • ND.of Air Cond. Tors Total INo,ofAL9-iagDews 'J` e•-, r No-of Was- Disposers ai -••,p umber 'Tons I'-•• ( a of a ono:devices I. 1 Na.of Dishwashers I TD Plc: I IDet e&on/4lertine Dov eros !Space/Area Heating KW' Loa!Or Mnmdpal Connection 0 Otaer I 1' J No.of Dryers IEeating Appliances KW Security Systems No.of Water No,of Devices or Equivalent U Heaters KW Si No, Si Ballast ofNo.of Pats Wiring: as Na.of Devices or I.. No.Hydromassage Bathtubs Eq>zivaleat No.of Motors Total HP ITtlecommnnicatioas Wiring No.of Devices or Equvalent i OTHER _ • Estimated Value of El .'c. Work:: additions!detail grderired oras required by the inspector of Wires. EEt Work to Start S . t�s-�a (When required by municipal policy.) Work o Start CO , mous to be roquened m accordance with MEC Rule 10,and upon completion INSU ' • GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent Thelandersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE INSURANCE BOND 0 OTHER 0 (Specify:) r fib' arida the pis and ' off p ruy, rhai th tC rm�an on this tspp&ea$on i trete and eompt FOtM NAME: Licensee �q oftO�f/ LICNO.: r` Ps Licensenbte• c.err •Q r Signature �/!/L LIC.NO: �+�•�.,� Y e license b arse.)a Sas.TeL No:5C _ yr/ Address: A mi '' 4 - _ _l 'Per M.G.L. c. I• s.x7-61,s- Alt TeL No.: �Cy1 %L"� OWNER'S INSURANCE‘Ti:- , ' aft Department Lane s Public nor hhave the liability Lin.insurance c. er •- R 'R. I I h rate tat the this Licensee does nor the liability 0ovencoverage no's t e required bel�• By my signature below,I hereby waive ttgtvremeat I am the(shale one owes owner's n ant Signe re. Telephone No. PERhIII FEE: S