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Home My WebLink AboutE-18-3681 Official Use Only i o,itts Commonwealth of Massachusetts Permit No. BLDE-18-003681 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.1/07] 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 ININK OR TYPE ALL INFORMATION) Date:12/22/2017 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) 947 ROUTE 6A 4' Owner or Tenant GEORGE THOMAS N TRS Telephone No. Owner's Address GEORGE ALICE M TRS,48 CYPRESS POINT RD,YARMOUTH PORT, MA 02675 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 0 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: add outlets,replace heaters(508-778-1801) 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 GeneratorsVA No.of Luminaires Swimming Pool Above ❑ In- 0 No.of Emergency L �1Qo i- grnd. grnd. F s No.of Receptacle Outlets No.of Oil Burners FIRERE ALARMS No.o /v/VrO,I\/� No.of Switches No.of Gas Burners Not of and Ito ini.iofiAe Deng DJNo.of Ranges No.of Air Cond. Total No.otAlerting Devices O Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained oesfr Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local LIMunicipal 0 Othe Connection O No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent (J No.of Water KW No.of No.of Data Wiring: f� Heaters Siens Ballasts No.of Devices or Eoulvalent No.hydromassage Bathtubs No.of Motors Total HP - Telecommunications Wiring: No,of Devices or Equivalent OTHER: Attach additional detail fdesired 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: John B Raimo _ Licensee: John B Raimo Signature LIC.NO.: 18352 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:71 NEARMEADOWS RD,WEST YARMOUTH MA 026735009 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:$100.00 • vl�omrnorru o�///aidaej�.•�/F1t. 6Lncisl se Only Q:_.-- a�' cc�� ((''�J Permit No. •L) -/�' �7/ �- 1 1JcPcrF."rrnE o{�Jcrv[ccJ � )7 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fac Checked �, NI ' Rev. 1/073 (lezve blenh) / % APPLICATION FdR,PERMIT TO PERFORM ELECTRICAL WORK All work to be paiormd in accordance with the Massachusem Electrical Code(MEC),527 CMR I LH (PLEASE PRINTThr INK OR TYPE ALL INFORMATION) Date: ` 1` City or Town of: yA�QU'g To the Inspe oro Wires: . By this application the)mdersiped •' s note o his or her intention to perform the electrical work descnbed below. Location (Street&Number) / F - OWner or Tenant Sl n: ,l / a S ..• Telephone No. Owner's Address S 4---€' Is this permit in conjunction with a building permit? YesNo Purpose of Bmin`mg ❑ -. ❑ (Check Appropristn Boz) l cudtsurr .fr Utility Authorization No. Existing,Service Amps / Volt Overhead �7 4L1 Undgrd❑ No.of Meters _ New Service nips / Volt OverheadUndgrd ❑ ❑ NO.of Meters w...Sz IN Number of Feeders and A mpacitp . Location and Nature of Proposed Electrical Work-. .'�7Q C d! n �PO�[•!1 f'ti'R ` •• - ..... _ _ Completion of the foIIc,n,,;table mTay be w�eved by the Inspector of Wirer. No.of Recessed Luminaires H. of Cert-Busy.(?addle)Fans No.0f Total Traasiormers A'VA • No. of La Outlets INo.ofHotrobs (Generators • b'VA ' 1 No.of Luminaires ISRim,,,,,,g Pool °jbvve ❑ Ia- 0 No.of amerpemry Ltghtm; crud. mad. IBnt+rry Un± • Na. of Receptacle Crudet . No.of Ort Burners ' is (FIFE ALARMS INo.of Zones t� ,� No. of Switches No, of Gas Burners No.of Detection and (� , ._. IaitiatiaH Devices No.of Ranges Total 1141 C,� � INo. of Air Cond. Tons No.of Alerting Devices '�•.�� No.of Wzste Disposers IHeatPump (Number ('Tons !KW Na of Self-Contained cm •. Totals: Deteeiion/Aleridau DevirJ cv 1Q No. of Dishwashers ISpacrJJAr a H�eag ICVJ' Local D Mtmidgal W c j )crsHu IConnection 0 �°? /0/ U l No.of Dryers IHeattag Appliances ecartty Systems: W No,of W ater No.of Devices or Equivalent No. of No, of Data Wiring: l[J t7 j Heaters KW Signs Ballasts No.of Devices or Equivalent I lir L" ` No.Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent O 111ER: • Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of E.ectical World 4 cad Work to Start: (When re 9�by municipal policy.) �; /I Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue tmless the licensee provides proof of liability insurance inclnrling"completed operation"coverage or it substantial equivalent The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing oce. CHECK ONE: INSURANCE 0 BOND ❑ OTHER 0 (Specify:) r certify, under the pain iced penalties o f!perju y,that the information - u'apptic..•.n is true and complete FIRM NAME; 4 s vw .. (t inc Licensee: � ET s' Signature�C / LIG NO' (If applicable, enter"exempt"in the icense her line. , / A LIG NO.:�$�!/�/(- Address ABus.tTeL No. �C1:�) �4 I S .e Alt TeL No.: J *Per M.G.L. C. 147,s. 7-61,security work reyui,.a Department o ' blic Safety"S" 'cense: Lie.No. / — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nor have the liability insurance coverage n — required by law. By toy signature below,I hereby waive this requirement I am the(cheek one)0 owner o Owner/Agent ❑ wvner's Stgnature Telephone No. PERMIT FEE: $