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Home My WebLink AboutBLDE-18-002222 }Jiiik Commonwealth of Official Use Only Permit No. BLDE-18-002222Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.I/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:10/162017 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. •/ Location(Street&Number) 44 CAPT PERCIVAL RD �- -62 6o Owner or Tenant HOFF ELIZABETH A ' _ Tele hone No. Owner's Address 44 CAPT PERCIVAL RD,SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No '` ,ropriate Box) Purpose of Building Utility Auth I,ild'r'i 0 Existing Service Amps Volts Overhead 0 Un..;"1 ar. ' ers New Service Amps Volts Overhead 0 Undgr' s,'`• h , , rre7 Number of Feeders and Ampacity S � Location and Nature of Proposed Electrical Work: Replacement boiler o /� l IP Completion of the following table ma�•3 • : sy the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total �� KVA Transformers '7 No.of Luminaire Outlets No.of Hot Tubs Generators J-B KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting CJ grnd. grnd._ ___ _ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 'Ton@$Total No.of Alerting Devices No.of Waste DisposersIleatPump Number Tons_L KW _ No.of Self-Contained • Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Ileating KW Local 0 Municipal ❑ Other: Connection No.of Dryers Beating Appliances • KW Security Systems:* No,of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Ileaters Siens Ballasts No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total liP Telecommunications Wiring: No.of Devices or Equivalent OTHER: • Attach additional detail ifdesired 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: ALBERICO ELECTRIC-FOR SEASIDE GAS SERVICE Licensee: Bruce Alberico , Signature • LIC:NO.: 11751A (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 5083624694 Address:20 Pint St,Yarmouth Port MA 02675 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 `f 4- ti(-4(c, i Isla 2/10/P qlc 7/2-110 lie . 'clip 9(ES(68 kf_____ I IL.,- Cearesoowa t4-/M tt Official Use Ott -- r Thefarlar.aioian.�'imko Permit No. Cg -`�G'�� I • Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev.1/07) (leave blank) 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 PRIM'IN INK OR TYP ALL INFORMATION) Date: Iv ) e 7 City or Town of: 'lIJ $C k. To the Inspector of Wires: By this application the undersigned;lives notice of his or her intention to perform the electrical work described below. Location(Street&Number) -t CaP7 PeeLp. t- OwnerorTenant - LIZ +b FP Telephone No.51543it-62C.O Owner's Address 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 t Volts Overhead❑ Undgrd 0 No.of Meters New Service _ Amps t Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: AI bet& SPG-. Completion of thefollowintfable may be waived by the Inspector of Wires No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above o In- o No.of mergeocy t.tghtmg Ent Ind. Battery Units No.of Receptacle Outlets No.of OU Barmen FIRE ALARMS No.of Zones No.of Switches No.of Gas BurnersNa of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons Total g No.of Alerting Devices Na of Waste Disposers Totals: Pump Number Tons KW No.of Self-Contained Totals: Deteeuon/Akrtin Devices No.of Dishwasher S ce/Ara HeatingKW Iwai❑ Munlc4 l ❑ Omer Pa C]�omnectiom No.of Dryers Heating Appliances KWN of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KWSigns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Tel poomo.of Dnvkkewnr EWiriEquivalent OTHER: Attach additional detail l(desired or as required by the inspectorgfWires. 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 hs 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 lja BOND 0 OTHER 0 (Specify:) 1 certify,under the pains and penalties of perjury,that the information on this application Is true and complete. FIRM NAME: Alherirn Flprtrir //��((�� LIC.NO.: 2RR77F (1) Licensee: Bruce Albericn Signature�aa.e..L)W).�ma—t, LIC.NO.: 11751 A (M) (lfapplicable.enter"exempt" us.In the license number line.) BTel.No.• 508-362-4694 Address: 20 Pine St-Yarmouth Port.MA 02675 Alt.Tel.No.. *Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. 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)n owner n owner's agent. OwnSidurree at Telephone Na I PERMIT FEE: S 4 x'31