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Home My WebLink AboutE-19-2852 a tit Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-002852 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 IN INK OR TYPE ALL INFORMATION) Date:11/8/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertomi the electrical work described below. Location(Street&Number) 15 WAMPANOAG RD Owner or Tenant GOSSELIN ROBERT C Telephone No. Owner's Address GOSSELIN SANDRA J, 15 WAMPANOAG RD,SOUTH YARMOUTH,MA 02664 Is this permit in conjunction with a building permit? Yes ❑ No 0 (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: Install generator. 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 1 KVA 12 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting Rind. grnd. 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. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin2 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 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: James M Venuti Licensee: James M Venuti Signature LIC.NO.: 15798 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 JOSIAHS PATH,W BARNSTABLE MA 026681340 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"5"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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 �a2t f 19 /,9 x`61 " 36/ie �� _. ` -._., C..otnnwnmralth of///euac eb Official Use Only �� /c7 �a Permit No. alai t-�J 5� --7_:1 _ o .lire Javices = Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS "Rev. I/07] ' (leave blank) APPLICATION FOR: PE• RMIT TO PERFORM ELECTRICAL WORK 4A3 All work to be performed in accordance with the Massachusetts Elccnical Code(MEC),527 CMR 12.00 g)' PLEASE PRINT IN INK OR7YPEALLINFORMATIONJGiiM1LL Date: l/-7—/10 x� 0� City or Town of: YARMOUTH To the Inspector of Wires: . By this application the pndersigned gives notic7.e of his or her intention to perform the electrical work described below. Location(Street&Numberlel S. Y Owner orTenant )2.01,.....-4- Eos, lin Telephone No.$O Owner's Address /g6� Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) I i Purpose of Building w Utility Authorization No. I `c Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters _ C*+ ¢ New Service ❑ U¢d d w Amps / Volts Overhead gr 0 No.of Meters I r o Number of Feeders and Ampadty • L 0 O i i Location and Nature of Proposed Electrical Wort ] Kw. S+n.Lt �1tC Ili 2 -J 1"Z. J IX 5 m' Completion of the jollowiny table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Total No.of Luminaire Outlets Transformers KVANo,of Hot Tubs Generators KVA No.of Luminaires Swimming pool Aboved. ln- Ivo.of N.mergeury Lighting - Aragrad. ❑ Battery Units No.of Receptacle Outlets . No.of Off Burners FIRE ALARMS INo.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 Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating ICW Lay 0 Municipal Connection 0 other No.of Dryers Heating Appliances KW Security Systems:` No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: - 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 ifderire4 or as required by the Inspector of Wires. Estimated Value of Electrical World (When required by municipal policy.) j 0 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 ca is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE CrLy' BOND 0 OTHER 0 (Specify:) o I cernfy, under the ,airrs and penalties ,f penury,that the information on this applicatio : true and complete. FIRM NAME: arra? 44- _La_a r tri CC-61G, .L n / LW.NO.: Licensee: ( S whcs Mc erSi Signature # / ' - LIC.NO.: • Address: dresrble,en "a in the lin S ^�( e{!' e) - I. Bus.TeL Na. Addresr. ` � ` 16Ste h$ f c'1 h LJ t t�jr rpt J-z �K- J Per M.G.L.e. 147,s.57-61,securitywork requiresyArlt.TeL No.: - OWNER'S INSURANCE WAIVER: I am are tht thDepartmenticensee does not have the liabilityLin.No. irequired bylaw. Bymysignature insurance coverage normally gnature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. t Owner/Agent 0.1 Signature Telephone No. I PERMIT FEE: S 'l5