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Home My WebLink AboutE-19-2670 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-002670 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:11/2/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to per the electrical wc(rc�scyi � Location(Street&Number) 28 MACOMBER DR Inc-I' `�� Owner or Tenant BOISSE GEORGE H III Telephone No. Owner's Address BOISSE DEBORAH J, 11110 REAMER WAY APT 302,MANASSAS,VA 20109 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd ❑ No.of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Service reconnect. 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 0 In- ❑ No.of Emergency Lighting grnd. Rend. 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 Initlatine 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: Defection/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 Siens 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: Richard L Serpone Licensee: Richard L Serpone Signature LIC.NO,: 6910 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 183 PINE ST,YARMOUTH PORT MA 026752374 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 Oftrn tiMej t (Ntm 74 t) ,7), ` l.ammonwea&of rr/aeeaeLette . Official Use Only __.��_ 2/Dar:matt of..`ire Services Permit No. ([7Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. I/07] ' (leave blank) APPLICATION FORPERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 12.00 (PLEASE PRINTININKOR TYPE ALL INFORMATION) Date: J/ka v City or Town of: YARMOUTH To the I ecto o fres: By this application the undersigned gives noti�,j�of his or her' tention to perfo the electrical work described below. Location(Street&Number) s4� ive-fropelber e %nu. 0.- ft�ov'f Ownefor Tenant / v'i'4 PN y o Telep one No. Owner's Address ,y ,,�,h r1�J Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Az) Amps /,,7cJ/ ZcejVolts Overhead in Ll Undgrd fg No.of Meters f New Service _ Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Loeagon and Nature of Proposed Electrical Work: .we'c' r�ee/ ..4c.orr .t, hi€ L er. e5st-e�24-f s .rl9Are, ioof veva. va. No.of Recessed LuminaNo. of the following No.leamay be waived by the I pector of Woes. No.of Cert-Susp,(Paddle)FansTotal Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA Na.of LuminairesSwimmi¢g Pool Above ❑ In- No.of£mergeucy Lighting - ernd. grnd- 0 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 J • • Initiating Devices No.of Ranges Na.of Air Coml. Total No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers • Space/Area HeatingKWMunici al Local0 Connection 0 e'er No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Heaters Signs Ballasts Data Wring; Na of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: Na of Devices or Equivalent OTHER: Attach additional detail ifderired or as required by the Inspector of Wirer. 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 2BOND 0 OTHER 0 (Specify:) I certify,under the pa' an pen s of erjury,that the information on this application is true and complete. FIRM NAME: IC�gga,r erOth,c LIC.NO.' , a Licensee: r I net 1'ySiignature ,�,d... I a licabl enter"erempt"in r license number line) "mac LIC.NO.:F�L� �. (f pp e62 Bus.Tel.No:� Address: /f/3 !sere Sf J Per M.G.L.c. 147,s.57-61,security work requires Department of Public SafetyAIL Tel.No-: — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilityLic.No. —� e re red b law, By insurance coverage normally q� Y my signature below,I hereby waive this requirement. 1 am the(cheek one)0 owner 0 owner's agent. t Owner/Agent Signature• Telephone No. .... I PERMIT FEE: $