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Home My WebLink AboutE-19-298 `1* �5 ✓ a Commonwealth f Official Use Only fel Massachusetts ,.....„1. No. BLDE-19-000298 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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:7/16/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his of her intention to perform t electrical wr described beloy Location(Street&Number) 31 GROUSE LN I/`+l itrf tde� fr Owner or Tenant--64RKJN2AAH16KscstQ=TR.S— - Telephone No. Owner's Address LA-. _- , - - •_ ' • _• z . 4., _ - - . s•:.:. 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 ❑ Undgrd ❑ No.of Meters • Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for bedroom&bath addition. —7- Completion /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 Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting gmd. grid. Batten,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 initiation 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/Alertinc Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ 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 Siens 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: John B Raimo Licensee: John B Raimo Signature LIC.NO.: 18352 &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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 au, 0(7fie it (Gobtttotwit 465a'Mies at3(6) ivot n en3,4„ ,Q uotr(wi, .e, Not* e/e i(e e i NIA :461(8 t fM4c- '/3f 9Ke ,I n �� yyyy . antlitonu�ie&o�MCW. CLieltd Official Use Only �k ryry, c7 �a En-023 e 4 = tic_ ,,,,i.„,,o f.yirr J Permit No. in'5 ;l,,s Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. 1/01 . (leave blank) APPLICATION FOR• �PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME 527 , 12.00 (PLEASE PRINT IN INK OR TYPE ALLINFORMATTON) Date: 7/ //? City or Town of: YARMOUTH To the Inspec or ofires: By this application the undersigned gives no,e of his or her intention to perform the electrical work described below. . Location (Street& 3 Number) ' b✓tau Lw (�� Owner orTenant .tet (� ( l SAMA-, Telephone No. tj�I► Owner's Address Is this permit in conjn coon with a building, Yes ❑ No 0 (Check Appropriate Box) / Purpose of Building _ Utility Authorization No. —Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters i New Service Amps / Volts Overhead 6.'.1 r_______173 0 Undgrd 0 No.of Meters w\ m Na Number of Feeders and Ampacity r N ( c= 'ILocation and Nature of Proposed Electrical Work: �ct . �.a4 Y t L �' / r �j t /`c�+. /1P p V`1 W .--1...41.,5 r completion ofthefollowin table nip,be waived the/ �fY� f b1' Inspector of Wirer. r leo.of Recessed Luminaires No.o Total .� No.of CeiL-Snsp.(Paddle)Fans Transformers KVA LU a 2 0.of Luminaire Outlets No.of Hot Tubs Generators KVA x leo.of Luminaires Above In- No.of Umer en Lighting • . Swimming Pool d ❑ fid. ❑ Battery units ry 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 Na.of Air Cond. Ton No.of Alerting Devices • No.of Waste Disposers Heat Pomp I Number I Tons I KW No.of Self-Contained - Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' IMunicipal 0 Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* - No.of Water No.of Devices or Equivalent Heaters KW No of No.of Data Wiring: Sips 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 EJderire4 or as required by the Inspector of Wires. Estimated Value of EI ctrical Work (When required by municipal policy.) Work to Start:Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C ERAGE: 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.) !certify,under the pairs and penalties of perjury,that the infortnatio n is appficati n is true and complete. FIRM NAME: /Ca cLAl r:Le C ik LI-C. �i�.(�'S1� Licensee: B n � LIC.NO.: AM 1 -ct„ Signature 'C.,, LIC.NO.: Ir (If Address: y rD'ez¢trtW in thefiae e nwnbe n 4 i y YV I �C3� Bus.Tei.No: Y �S • Addresr. /J/ /St7}c e4 /ref 61-3- �c�1 j 'Per M.G.Ij/c. 147,s.57-61,securitywork requiresi Alt Tel.No.: �t`t 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 went. r Owner/Agent Signature, Telephone No. ( PERMIT FEE: S 7S--