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Home My WebLink AboutBLDE-18-003469 ,d�p� Commonwealth of Official Use Only gt;4;41`' Massachusetts Permit No. BLDE-18-003469 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/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:12/13/2017 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) 12 PINE GROVE VILLAGE S -3 62-c3c0c, Owner or Tenant DELUCIA NANCY D TR - Telephone No. Owner's Address N L DELUCIA TRUST, 12 PINE GROVE,YARMOUTH PORT,MA 02675 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 0 Undgrd 0 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: Install security system 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 1 Total Transformers KVA No.of Luminaire Outlets No.of hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- CINo.of Emergency Lighting grnd. grad. 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. .Tootal No.of Alerting Devices No.of Waste Disposers Ileat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other. Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total IIP 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application Is true and complete. FIRM NAME: Stephen C Ehrlich Licensee: Stephen C Ehrlich Signature LIC.NO.: 1355 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:369 CENTRAL ST.UNIT 9,FOXBOROUGH MA 020352637 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 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: $80.00 ( -9A 'Y519 h 0 eS e/7/47 �- of - La iIlt �//q I Otfici Us s ,7 mmonwaa o/VZ 45achtcsettd • Apartment Permit No. a a fa Apartment o/.ire Straw Occupancy and Fee Checked tad BOARD 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: December 07,2017 City or Town of: _Yarmouth Port,MA_ 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) 12 Pine Gry Owner or Tenant Liberato Delucia Telephone No. (508)362-5366 Owner's Address 12 Pine Gry Is this permit in conjunction with a building permit? Yes r . _No -it (Check Appropriate Box) Purpose of Building Residential Utility Authorization No. Existing Service Amps / VoltsOverhead __^_Undgrd i ;____No.of Meters New Service_ Amps / Volts ,Overhead UndgrdNo.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of a low-voltage,wireless burglar alarm system. 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 grnAboved. grnd.In- No.Battery of EUnitsmergency Lighting , No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No 1 of1tDia ectionting Devand ices , No.of Ranges No.of Air Cond. Total nal No,of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 1 Municinectiopaln Other Con No.of Dryers Heating Appliances KW Sec No of Devices ity or Equivalent No.of Water KW No.of No.of Data Wiring: Beaten 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 Electrical Work: $850.00 (When required by municipal policy.) Work to Start: December 07. 2017 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 and penalties ofperjury,that the information on this . .plic•th n is e and complete. FIRM NAME: D-fender ecu 't Co. .an i LIC.NO.:C 1355 Licensee: 7C4 YiW If - Signature . Arr Zlitalar LIC.NO.:D 434 (If applicable,enter"exempt"in the license number line) ____ _____ Bus.Tel.No.: 800-689-9554 Address: 3750 Priority Way S Drive, Suite 200.Indianapolis,IN 46240 / Alt.Tel.No.:866-502-3559 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. SSCO-001258 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) 1 owner I owner's agent. Owner/Agent Telephone Signature No 'PERMIT FEE: $