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Home My WebLink AboutE-18-1080 a Commonwealth of Official Use Only Sr .‘I) MaSSachusettS Permit No. BLDE-18-001080 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.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:8/25/2017 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perlorm the electrical work described below. Location(Street&Number) 19&21 WOOD RD Owner or Tenant MELLO JEFFREY T TR Telephone No. Owner's Address JEFFREY T MELLO TRUST,21 WOOD RD,SOUTH YARMOUTH,MA 02664 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd ❑ 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: New residence O� Completion of the following t m •'�j % . he Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of dp Total Transformers O KVA No.of Luminaire Outlets No.of Hot Tubs Generators A No.of Luminaires Swimming Pool Agrnd. gbove ❑ In-rnd. ❑ No.of Emergency Lig O •Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of No.of Switches No.of Gas Burners No.of Detection and /s yzyInitiating Devices SJNo.of Ranges No.of Air Cond. Total No.of Alerting Devices B Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers Ileating 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 So.of Motors Total IIP 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: BRUCE M ALBERICO Licensee: Bruce M Alberico Signature LIC.NO.: 11751 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:20 PINE ST,YARMOUTH PORT MA 026751837 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$180.00 ets.06t 14s 1e IC/v4nee" '� — Cones ow &ofMassachuseffs _ • UUseOVJPermt No. L 8o=L>c apartment o{ 7ira Services J, Occupancy and Fee Checked ' BOARD OF FIRE PREVENTION REGULATIONS fRev. 1/073 (leave black) •APPLICATION FOR• :PERMIT TO PERFORM ELECTR CAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ,527 1200 (PLEASE PRINT IN INK OR TYPE ALLINFORMATIO?) Date: Z‘c. $7 City or Town of: YARMOUTH To the Inspector of fres: . By this application the pndersigned,gives notice of his or her intention to rm the electrical work described below. Location(Street&Number) '1st Ulf)t) S Owner orTenant `r4}} ` ' 1 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes L(X No 0 (Check Appropriate Box) Purpose of Building I J&U,y h kg.e_ Utility Authorization No. Existing Service¶ oe Amps rd / ZCOVolts Overhead Q Undgrd No.of Meters New Service %' Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampaoty -- • Location and Nature of Proposed Electrical Work: .. _ ___ —.._. Completion ofthefolfow na table maybe waived by the Inspector of Wirer, ' No.of Recessed Luminaires No.of Cerl.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators • INA • • No.of Luminaires Swimming Foot &e ❑ gid. ❑ gift +.rry Un 4ency r..rahtmg No.of Receptacle Outlets . Na of OH Burners 'FIRE ALARMS INo.of Zones " No.of Switches No.of Gas Burners Na of Detection and • l:nitiatine Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump Number Tons KR' No,of Sett-Contained Totals: Deteetion/Alertine Devices No.of Dishwashers Space/Area Heating KW' Local❑ Mnaiapal Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:` No.of Water No.of Devices or Equivalent KW No,of No.of Data Wiring: Heaters I . Ballasts Signs Na of Devices or Ecuivaleut No. Hydromassage Bathtubs INo.of Motors Total HP Telecommunications Wiring: Na of Devices or Equivalent O k HER: Attach additional detail f desired or as required by the Inspector of Wires, Estimated Value of Electical 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 covers s in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCEBOND 0 OTHER 0 (Specify:) I cer45', under the pains and pennh9.r of perjury,that the information on this application is true and compfd FIRM NAME: LIG NO. , Licensee: Signatu camOftt-a.4—).- LIC,NO:: AS 27 (If applicable,enter"exempt"in the license number line) Bus.Tel.No.� Address j Per tvLG.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lel. tmNo. OWNER'S INSURANCE WAVER I am aware that the Licensee does not have the liability insurance coverage normally required bbyella`. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owners agent Signature Telephone No, I PERMIT FEE: S