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Home My WebLink AboutE-19-001622 �'�� Commonwealth of Official Use Only E Massachusetts Permit No. BLDE-19-001622 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ,iRev.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:9/18/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 923 ROUTE 6A UNIT R Owner or Tenant CHAPTER TWO LLC Telephone No. Owner's Address C/O IVANA LIEBERT, PO BOX 206,YARMOUTH PORT,MA 02675 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 Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install receptacles. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cei4Susp.(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. Batten,Units No.of Receptacle Outlets 10 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 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 Siens Ballasts 4No.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 ❑ 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: ALBERICO ELECTRIC-FOR SEASIDE GAS SERVICE Licensee: Bruce Alberico Signature LIC.NO.: 11751A (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 5083624694 Address:20 Pint St,Yarmouth Port MA 02675 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:$80.00 c /14 C latninontaea&a/ aesac (fs C—Official U=ell Z2 =r� t c'7� c7 �s Permit No. _ =-711.117- ararfnsenf al as Jeevice! r"1 ,:_ t)_ Q • .�4 BOARD OF FIRE PREVENTION REGULATIONS Occupancy I/a7cyandFeeCnk) Rev. lro7) (leave blank) LU b 22 I FPPLICATION FOR:PERMIT TO PERFORM ELECT IC L WORK .. I Q All work to be performed in accordance with the Massachusens Electrical Code(ME jWir ;12. LII t CO tow(" SEPRINT ININK ORTYPE ALL INFORMATION Date: j1 Sr 1 • o , a� City or Town of: YARMOUTH al :, this application the undersigned To the Inspector o gn gives notice of his or her intention to perform the electrical work d bed below. cation(Street&Number) °2I �A n�-V Se{� J� l_L�A� S Ll 1,I i m ..s wner'orTenant CAN fir t- 2 LLQ Telephone No. a wuer's Address - Is this permit in conjunction with a building permit? Yes ry��No L'�J ,.0 (Check Appropriate Box) Purpose of Building k )e^ \ L S R\o A) Utility Authorization No. Existing Service)Or) Amps 17 U/ZQQ Volts Overhead ❑ Undgrd[l-- No.of Meters 1 New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity -- Location and Nature of Proposed Electrical Work: ea flee e�r\c\t.S , G F 5 i r Completion of thefollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires Na oCCesl Snsp.(Paddle)Fans • islo.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 INo.of Zones No.of Switches No.of Gas Burners No,of Detection and • Initiating Devices Total . No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals:f Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local MJWctpal - ❑Connection 0 °th?r No.of Dryers Heating Appliances KW Security Systems:` No.of Devices or Equivalent No.of Water No.of Heaters KWNo.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromass age Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail Ideated or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start 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 coyerrira force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:) I cernfy,under the pains and penalties of perjury,that the in anon on this application is true and owlet FIRM NAME: LIC.NO.: 11 r)6'Licensee: Signature ()Inapplicable,enter"exempt"in the license number line.) 1(1,�}�s. Lel. Address: Bus.Tel.No.-� Alt Tel.No.:� rr��,,,,6 4 g.6 J *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. — `�� — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally n�y gc required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agent t Owner/Agent ( Signature Telephone No. I PERMIT FEE: $