The URL can be used to link to this page

Home My WebLink AboutBLDE-19-003176 Commonwealth of Official Use Only #E.OF A Massachusetts Permit No. BLDE-19-003176 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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 PRMT IN INK OR TYPE ALL INFORMATION) Date:11/21/2018 City or Town of: YARMOUTH A elnspector of Wires: By this application the undersigned gives no ice o is or Cr in en ton o per onu IF lea work. Med below Location(Street&Number) 315 LONG POND DR O a t, i3 Owner or Tenant COOPER ERICK W Telephone No, Owner's Address 131 PLEASANT ST,SOUTH YARMOUTH,MA 02664 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 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: Receptacle for gas insert. Completion of the following table maybe 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- . CINo.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 Tons 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 ❑ 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: JOHN M PIMENTAL Licensee: John M Pimental Signature LIC.NO.: 27968 Ufapplicable,enter"exempt"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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 1I 23f15 lg ✓ ''•'- � /� yyyyt W.li _ (ammonwea ofett/acdacL.th Ojffcuval Use Only/_�+ arpagmal of..ave-gamine! r.Permit No.-tea"(-3(�"� Occupancy and Fee Checked LL•�� BOARD OF FIRE PREVENTION REGULATIONS Rev. I/07] leave blanc) l APPLICATION FOR•PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 1200 (PLEASE PRINT INI IC OR TYPE ALL INFORMATION) Date: I/-RI-I g City or Town of: YARMOUTH To the Inspector of Wires: . By this application the t,mdersigned gives notice of hi or h�intention to perform the electrical work described below. • . Location(Street&Number) I S Oh 0 62 erorTenant 20y I o vtrn TelephoneNo.S#f�gs ❑ —0•• 'er's Address 5 otww6. W m' permit in conjunction with a building permit? Yes ❑ No > ,_ (Cheek Appropriate Box) N • Eu .ose of Building jam, .et.ype.1 Jr' a Utility Authorization No. W t��1 '6zi.:agService_ props / Volts Overhead Undgrd 1 ❑ gid❑ No.of Meters V e Service Amps / Volts Overhead 0 Undgrd 0 Ne.of Meters — o • Iyl Z IF,. bei of Feeders and Ampacity n I w i-.---- -�tion and Niture of Proposed Electrical Work w R cc e_ .ec_ Per /S a s Z'r1 herr. Completion of thefollowing.tab_lle may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CetltiCnsp.(Paddle)Fans • No.of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming pool Aboved. In_ Na or tmergency Lighting , gmgrad_ 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 Initiating Devices To 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 1 I Detection/Alerting Devices No.of Dishwashers SpacelArea Heating KW !Aral Municipal - 0 Connection 0 Other • No.of Dryers Heating Appliances KW Security Systems:' No.of Water No.of Na of Devices or Egtuvalen[ Heaters KV No,of Data Wiring Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring Na of Devices or Equivalent OTHER _ Attach additional detail if derired or as required by the Inspector of Wires. Estimated Value of Electtica Work: (When required by municipal policy.) Work to Start 11-19—/Y 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 9 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties ofperjury,that the information on this application is true and complete FIRM NAME: IC NO.: Licensee: d 14 / ' r Signature L% J/e t I.ICNO.: 794bi (Ifapplicablwnter" tempt• ' the license mer line) _ Bus.Tel.No:SO 7.2..Address: !ea, 2 Y,Pst tap-4,e Y714_ oa fL/ work requiresAlt.Tel.No.: J Per M.G.L.c. 147,s.57-61,security Department of Public Safety"5"License: Lie.No..------ ice - 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)0 owner 0 owner's agent. t Owner/Agent g SignatureTelephone No. I PERMIT FEE: $ ��