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Home My WebLink AboutBLDE-18-003437 • p ty Commonwealth of Official Use Only • telMassachusetts Permit No. BLDE-18-003437 �' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.(/07[ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to he performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:12/12/2017 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of has or her intention to perlunn the electrical work described below. Location(Street&Number) 22 BLISCOTT AVE Owner or Tenant BROWN GWENDOLYN Telephone No. Owner's Address 1896 RIVER ST, HYDE PARK, MA 02136 Is this permit in conjunction with a building permit? _ Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. 223. Existing Service Amps Volts Overhead ❑ llndgrd 0 4 jjjjjjlllIII��crs New Service 200 Amps Volts Overhead 0 UndgrJ. ❑, a.i�Sy�'� Number of Feeders and Ampacity 4 j. O Location and Nature of Proposed Electrical Work: Upgrade service �/////�/ Completion of the following table mayiX>•' t6 y i / .s7 of(Vires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of /\ ml Transformers C/\`7VQ)� VA to No.of Luminaire Outlets No.of!lot Tubs Generators VI ' aL VA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergencyhtin v grad. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Cas 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 NW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Ileating MW Local 0 Municipal 0 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 No.of Motors Total IIP Telecommunications Wiring: No.of Devices or Equivalent OTIIER: 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 �I coverage is in force,and has exhibited proof of same to the permit issuing office. 'f!,'• CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) ^ �51v I certify,under the pains and penalties of perjury,that the information on thise'application is true and complete. FIRM NAME: THOMAS A UMBRIANNA Licensee: Thomas A Umbrianna Signature LIC.NO.: 38324 (If applicable,enter"exempt"in the license number line) Bus.Tel.No.: . Address:22 BOW ST,CARVER MA 023301230 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) 0 owner 0 owner's agent. Owner/Agent Signature '% it Telephone No. PERMIT FEE: $50.00 (Gut( '\Q a QP Pert Wficr//erzonsz-CaotMo kletett( fl C 1i. nVb) akin Nice t(/Zf« rE. A /� yy� ti ;.,� fficra Use Only t.ommonrvea�i ei rr/addac�iuedld C �— Only Ii(Mrlit e i c7 Permit No. 34137 il* ± Theparinvnt./. ire Serviced fleer a Occupancy and Fee Checked i- F. BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),,527 CMR 12.00 (PLEASE PRINT IN INK ORTYPiE Na!LINFORMATION) Date: !_ 20/7 City or Town of: Aggaif p/ To the Inspector of Wires: By this application the undersignedgives notice ofhi s or her intention to perform the electrical work described below. 22 f3 4 Location(Street&Number) r 0n— ,4-vr Owner or Tenant Telephone No. 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. 22-3b/1 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: I fP/j-064JQ-SO20 CC Ze.1y AM/Cr Completion ofthe following table may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Tr.of KVA Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Agrbnod. grad.ve ❑ In- 0 NoBatte.ofry EmergencyUnits Lighting No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones oNo.of Switches No.of Gas Burners Na Initiatingon nDeteand Devices TNo.of Ranges No.of Air Cond. Too I No.of Alerting Devices Na of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained po Totals: Detection/Alerti g Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection /-, other No.of Dryers Heating Appliances Key SecNatyof I)evicms:*es or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Tel No. f 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: 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 cov s m force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify,under the pains and pen'hies of' duty,th, the information on this application is true and complete FIRM NAME: //d /i/`i/ ' ' . AAS-w "-/L. d LIC.NO.: f/&9' Licensee: ,U ang14A,,.z Signature_, LIC.NO.: (if applicable,inier "exempt;in the license number line.) Bus.Tel.No.'�'jRt t95 'P:iez" Address: Z2- �ut.. Sr en.e nil /44 Q2336 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)0 owner 0 owner's agent. Owner/Agent PERMIT FEE:$ �� Signature Telephone No.