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Home My WebLink AboutBLDE-19-003849 N Commonwealth of Official Use Only A Massachusetts s Permit No. BLDE-19-003849 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:1/2/2019 City or Town oft YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 12 SHELTERED HOLLOW LN Owner or Tenant FRIGAULT BRENDAN J Telephone No. Owner's Address 16 LEE RD.SHARON,MA 02167 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 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: Septic pump&alarm.Repairs to U/G service. • 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- 1:1No.of Emergency Lighting grnd. grnd. Battery 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 Initiatine 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 1 Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 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 Sins Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 1 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 0 BOND 0 OTHER 0 (Specify:) I cernfy,under the pains and penalties ofperfury,that the information on this application is true and complete. FIRM NAME: Michael F Simonis Licensee: Michael F Simonis Signature LIC.NO.: 16862 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 1488, EAST DENNIS MA 026411488 Alt.Tel.No.: *Pr 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:$7100 ___ C2MITIO. IUVIII41th of/r/amac its Offic' Use Only 2epartmeni c . ..7_ 110._,_ Jin�7 Permit No. Services ' ae BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked _sem ev. lro7] (leave blank) APPLICATION FOR,PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR I DO (PLEASE PRINT IN INK OR TPPEALL.!NFORMATIOl9 Date: /... /..2..? /7? City or Town of: YARMOUTH To the Inspector of Wires: • By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) f.2 Sh'e f$/. j44, /4 t Z't ) Z I OwherorTenant-A �� Telephone No. j m . I Owner's Address S 4-,wl"C i a CV < I Is this permit in conjunction with a building permit? Yes ❑ Na ❑ (Check Appropriate Box) ao Purpose of Building 1 I cit i` r A?' F-77-1.7 r 17 Utility Authorization No. s I w ;' Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters pi O I New Service Ams / P Volts Overhead 0 Undgrd ❑ No.of Meters /L------1i Number of Feeders and Ampacity Location� / and Nature of Proposed Electrical Work:��r �, 44,1 4 /ie✓Gf 11-411-Psi /Z Cr Pre et- t.•-.s-ezlC.it reset/d Sei.d/cc Completion of hefouawin2 table may be waived by the Inspector of Trims. No.of Recessed Luminaires No.of Cerl-Susp.(Paddle)Fans • Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.oltmergency Lighting - Ernd. grnd.- 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones - No.of Switches No.of Gas Burners No.of Detection and • Initiating Devices l No.of Ranges No.of Air Cond. Tos No.of Alerting Devices • No.of Waste Disposers Heat Primp I Number I Tons J KW No.of Self- Contained Totals: ! Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Leta,0 Municipal - Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of . No.of Devices or Equivalent Heaters No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP felecaram unicatioas 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 / Z/_,,ger Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO 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 (BOND 0 OTHER 0 (Specify:) %72j+"vct_er'S under the pains n• penalties of perjury,that the information on this application is true and complete. FIRM NA ECJ, + - ,s ��ee54-c ,r�/1/G LIC.NO.: o2 Licensee:AffjGf4--e-/ .S'lntortis• Signamr LIC.NO.•�-a ,� , (If applicable,enter"exempt in the license number line.) Bus. el.No: Addresr.7D• Bpk / y Pp .a.--. p . en �ZS„y/At_ pth649 Alt Tel. 6p j 'Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. 7 Q 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 Signature Telephone No. I PERMIT FEE: $