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Home My WebLink AboutBLDE-20-000028 w • Commonwealth of Official Use Only Permit No. BLDE-20-000028Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.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 IN INK OR TYPE ALL INFORMATION) Date:7/1/2019 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) 33 PAWKANNAWKUT DR Owner or Tenant REGONLINSKI APRIL Telephone No. Owner's Address 300 MASS AVE NW APT 1,WASHINGTON, DC 20001 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 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Repairs or renew 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 Abo 0 In- ❑ No.of Emergency Lighting grndve. 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 Totals: Detection/Alertine 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 Signs 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 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Robert J Carreiro Licensee: Robert J Carreiro Signature LIC.NO.: 19861 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:2 RITA AVE,S YARMOUTH MA 026641976 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:$50.00 yvo r Common reaps oti Massachusetts • Official Use Only �■ y .- 'imi / s Permit No. ter ' Apartment o Services cup 11 , {R ev. 1/07) _I BOARD OF FIRE PREVENTION REGULATIONS Ot an`y and Fee Checked (leave blank) APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 7 I. 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7 / /City or Town of: YARMOUTH To the Inspe or df Wires: By this application the Itndersigned gives notice of his or her intention to perform the ele work described below. Location (Street&Number) 3 3 A to g/4 AJ .'A 41 tK V i b • 49 Owner or Tenant Xjo6j/'Z -'7..Gp, 2, it/S/‹'/ Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No El (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Seri-ice ,/z7 Amps /2 2/, 1-MVolts Overhead ES, Undgrd�r ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No,of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: / �i# —SE�V e Ce: Completion of the following table may be waived by the Inspector of Wirer. No. of Recessed Luminaires No.of Cei1.-Susp.(Paddle)Fans No.of Total Transformers KVA No. of Luminaire OutletsGenerators KVA No.of Hot Tubs J No.of Luminaires Swimming Pool Abovem ❑ In- No.of timergency Lrghang - ga arnd. 0 Battery anus No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS f No.of Zones No.of Switches No.of Gas Burners No.of Detection and • Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump K I Number I Tons I KW --No.of Self-Contained Totals: _Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal - Local❑Connection ❑ Outer No.of Dryers Heating Appliances I, `Security Systems:* No.of Water No.of Devices or Equivalent No.of Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs - g No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail f desired or as required by the Inspector of Wires. Estimated Value of Electrical Work (WhenWork to Start required by municipal policy.) 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) f certify, under the a' d penalties of perjury,that the information on this application is true and complete. FIRM NAME: oee72r RRE/Rif) e-Ca /C/.,,.-1 LIC.NO.:L/=�� Licensee: 2:7- pt i tea Signature �r-- (If applicable,enter exempt'in the license number line.) LIC.NO.: �/ Address: . Bus.Tel.No.::-3q.,gt_45 j Per M.G.L. c. 147,S.57-61,security work requires Department of Public Safety"S"License: Alt Lic.No.el. � Q OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance covernally n required by law. By my signature below,I hereby waive this requirement I am the(check one ❑owner o Owner/Agent ❑owner's a tat Signature ill Telephone No. .• PERMIT FEE: $