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Home My WebLink AboutBLDE-19-001793 \6k Commonwealth of Official Use Only te® Massachusetts Permit No. BLDE-19-001793 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!NINK OR TYPE ALL INFORMATION) Date:9/25/2018 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) 63 HORSE POND RD Owner or Tenant BEHNKE JAMES M Telephone No. Owner's Address BEHNKE PATRICIA MCGUIRE,63 HORSE POND RD,WEST YARMOUTH, MA 02673 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 ❑ 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: Receptacle for fireplace blower. 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- o No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 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 Ton. 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 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 ❑ BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties oho-Jury,that the information on this application is true and complete. FIRM NAME: JOHN M PIMENTAL Licensee: John M Pimenta) Signature LIC.NO.: 27968 Of applicable,enter"evempt"in the license number line.) Bus.Tel.No.: Address:1158 E FALMOUTH HWY,EAST FALMOUTH MA 025365455 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:$50.00 Cic 1o(,11e n/� l�ommonwealth ry�of/r/adaach ,w Official Use Only y'T (7 Permit No. fry= 2eparimanf Inn.—ervices ?Vs Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. I/07) . (leave blank) o . APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 W co R (PLEASE PRINT IN INK OR TYPE ALL INFORMATI0P0 Date: 7014 /f t� City or Town of: YARMOUTH To the Inspector of Wires: Lu— n CI I By this application the undersigned gives notice of his or her intention to perform the electrical work described below. • +�ti� Location(Street&Number) ('q 3 (S-C Po'Act . (AA >' V fret V co waer'orTeaaat $ _ Telephone No.So�`��/7�� wner's Address m mIX D s this permit in conjunction with a building permit? Yes ❑ No [� (Cheek Appropriate Box) Purpose of Building ` U4.4.2ley Utility Authorization No. Existing Service Amps // Volts Overhead ❑ Undgrd❑ No.of Meters — New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: W I ISA For qt1S Taft/rt. Completion of the followinttable maybe waived by the Inspector of Wb-es. No.of Recessed Luminaires No,of CatSusp (Paddle)Fans No.of Total Transformers ICVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- No.othmergency Lighting mid. and. 0 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. Ton No.of Alerting Devices No.of Waste Disposers Heat PumpNumber Tons KW No.of Self-Contained Totals;I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local 0 Municipal Connection 0 other No.of Dryers Heating Appliances KW Security Systems;* No.of Water No.of Devices or Equivalent Heaters No.of No.of Data Signs Ballasts No.of D KW ices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No of Devices or Equivalent OTHER: Attach additional detail ifdesired or as required by the Inspector of Wires. Estimated Value of Electrical Works (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 cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [+�BOND 0 OTHER 0 (Specify:) I cernfy,under the pains and penalties of perjury,that the information on this ap lication it true and complete FIRM NAME: • / LIC.NO.: Licensee: ...i d II ' 14 •asa:I Signature d_ c_ ic.NO.: p (Ifapplicab! ente 'exem t' . then e 7 O r P ery�tuber line.) Bus.Tel.No.. .$ 7eL Address: re 4t) . es .'ulp ma caro y J `Per M.G.L. c. 147,s.57.61 security work requires Department of Public Safety"S"License: Alt. Tel.No.: „ Lic.No. - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally Ownerd/Agent by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent Signature Telephone No. 1 PERMIT FEE: $