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Home My WebLink AboutE-19-1606 '/ Commonwealth of Official Use Only A'a Massachusetts Permit No. BLDE-19-001606 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/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:9/17/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives nonce of his or her mtentton to pertorm the electrical work described below. Location(Street&Number) 22 MUSKET LN Owner or Tenant LEPORE OLGA M TR Telephone No. Owner's Address LEPORE REVOCABLE TRUST,22 MUSKET LN,YARMOUTH PORT,MA 02675-2127 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 100 Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service. 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. Batter,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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No,of Water KW No.of No.of Data Wiring: 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 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: MATTHEW F OSTROWSKI Licensee: Matthew F Ostrowski Signature LIC.NO.: 17228 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:71 LOTHROPS LN,W BARNSTABLE MA 026681354 Mt.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:$50.00 OIL a �1/(�/(r `ji. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 oF�. - / 09+Yg_ eiC�- IGO�(OFFICF,IUSERN Y) V E Q e ' _ TOWN OF YARMOUTH By ( ' Y1^.vBroE Fee: $ 7 2017 _ -- SEPI PERMIT NO. t<u , •zi tp�j�r T (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 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) ZZ VLtUSK&t L-4-6, 8" Owner or Tenant L_kf e4& 1 C 5:0 C e., Telephone No. Owner's Address Is this permit in conjunction with a building permit? ❑ Yes [; 'No (Check Appropriate Box) Purpose of Building S rN 144.... t A-vZ.c Utility Authorization No. Existing Service 100 Amps Ito / 2-4b Volts Overheaj Undgrd❑ No. of Meters f, New Service 100 Amps 17-0 / L'l b Volts Overheatj. Undgrd❑ No. of Meters l Number of Feeders and Ampacity _ Location and Natpre of Proposed electrical Work: CFht u&e-- O o T '.X t 5 7't N L- S S-✓t L-t- be) 'r'o Co22ASiwt .4- bat-Ice e.,otLA:i,aw 5e0 CA-10(c? . Completion of the following table may be waived by the Inspector of Wires No. o Total No. of Recessed Fixtures No. of Ceil:Susp.(Paddle) Fans Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA AboveIn- No.of Emergency Lighting No. of Lighting Fixtures Swimming Pool gmd. ❑ gmd. ❑ Battery Units No. of Receptacle Outlets No.of Oit Burners FIRE ALARMS No. of Zones No.of Detection and No. of Switches No.of Gas Burners Initiating Devices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices Heat PumpNumber Tons KW No. of Self-Contained No. of Waste Disposers Totals: [ Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local ❑ Connection ❑ Other Secutity Systems: No.of Dryers Heating Appliances KW No.of Devices or Equipvalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of'Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications or EWquivalent No.of Devices Equivalent Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may be issued 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 0 OTHERI (Specify:) (Expiration Date) Estimated Value of Elec cal Work: (When required by municipal policy.) Work to Start: 9 1 1 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify,under the pain and penalties of petjurr that the information on this application is true and complete. FIRM NAME: 14tbS112ocvc ( -C J-NL'., LIC.NO. t72-tem-- Licensee: A–Licensee: 1 . 0 grillas-DV./-4. - Signature f� �C _ LIC.NO. , (If applicable, enter"exempt"in the license number Iipe.) A,,Zus.Tel.No.: 77 L(--icy — L (t Address. 71 1-CmR0((.S -- 4 -+R- t C,` .4142,t-67-ii-‘4". Alt. Tel. 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)owner fl owner's agent.0 Owner/Agent Signature Telephone No. [Rev.04/00]