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Home My WebLink AboutBLDE-19-000073 • • ar Commonwealth of. Official Use Only til Massachusetts • Permit No. BLDE-19-000073 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.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 (PLEA SE PRINT IN INK OR TYPE ALL INFORMATION) Date:7/5/2018 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) 39 GARDINER LN Owner or Tenant CAMPAGNONI FRED Telephone No. Owner's Address CAMPAGNONI PATRICIA M,41 THURMAN PARK, EVERETT, MA 02149-4106 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd ❑ No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Relocate service. 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 ❑ In- ❑ No.of Emergency Lighting grnd. 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/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 ,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:) / ter*,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ROBERT GREER Licensee: ROBERT GREER Signature LIC.NO.: 22539 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:500 OCEAN ST,HYANNIS MA 02601 Alt.TeL No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S LNSURANCE 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:$75.00 Ce; tyeiW tf'Z € trilt8 zcricks 1 i • =via&ofa!latli! 1,, use Only .-\ =_dam eparlmenl o`yire Sias Permit No. 7 9 �s BOARD OF RRE PREVENTION REGULATIONS Occupa°cyandFeeChecked `� tro7) ' (leave blank) `J APPLICATION FORTERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7/6-i g City or Town of: YARMOUTH To the Inspector of Wires: . By this application the undersigned es notice of his or h intention to perform the electrical work described below. Location (Street&Number) •,? LGGA cit-,,eh 4 o.r Owner'or Tenant l ('� r7 p jr Q,^'t ,.}10 ( Telephone No. Owner's Address t4 at a eaev�ete-nI"LP.oa( ill Is this permit in conjung 'on with q building permit? Yes ® No 0 (Check Appropriate Box) Purpose of Building j�✓)tjeilt Utility Authorization No. f Existing Service to j Amps 12 /0'6 Volts Overhead Undgrd❑ No.of Meters i New Service Amps / Volts Overhead Undgrd 0 Na.of Meters kvJ Number of Feeders and Ampacity Location an Nature of Proposed Electrical Work: tip cje_k9fre- • •.G,6 t.c,ee 0 ,>lr . _ Completion ofthe following table may be waived by the Inspector of Wires. Z.N .of Recessed Luminaires No.of Cet1 Snsp•(Paddle)Fans No.of Total Ij-1 G NITransformers KVA o of Luminaire Outlets No.of Hot Tubs Generators KVA N • IQ No.of Luminaires Above In- No.or timer en ' tSwimming Pool 0g cY Lighting - �w gaud. gaud. 0 Battery Units iris' o NO.of Receptacle Outlets No.of Oil Burners Ls J FIRE ALARMS INo,of Zones - N..of Switches No.of Detection and -•a ,o No.of Gas Burners - •-' • Initiating Devices != No.of Ranges Na of Air Cond total - Tons' No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alertig Devices No.of Dishwashers Space/AreaHeatin KW' Municipal Heating Local Q Connection 0 Othiei No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of HeatersData Wiring: Sighs Ballasts Na of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - Na.of Devices or Equivalent OTHER: • Attach additional detail jdesired or as required by the Inspector of Wirer. Estimated Value of Electrical World (When required by municipal policy.) Work to Start: * /4//IC Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: 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 a BOND 0 OTHER ❑ (Specify:) I certify,under the`p�a• and penalties of perjury,that the information on this application is true and complete. FIRM NAME: h yet E tA( rc/ " LIC.NO.: 23°t A Licensee: � �Cr�` Signature _ LIC.NO.: (If applicable,enter'"e#e�mpr"in the license number line} /.,� us.Tel.No.• Addresr. /�-t(/ 0e antree Ke /4Vlr•-5/10•')9Miller IuAo �_ aCZ2� ] -5-Jsv J 'Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety _ IL Tei.No.: /"_a`� OWNER'S INSURANCE WAIVER: I am aware that Licensee does not have the liability insurance coverage normally .<� required by law. By my signature below,I hereb waive this "C Owner/Agent Y r equirement I am the(check one)0 owner ❑owner's agent. SignatureTelephone No. I PERMIT FEE: $ 7S— I