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Home My WebLink AboutBLDE-19-004703 `. -- Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-004703 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:2/19/2019 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 e ed Blow. Location(Street&Number) 87 STRATFORD LN OfvaouidC Owner or Tenant 'dAIv1t5 Telephone No. Owner's Address C^1.1.14 ....Ca eabl glNTSA, 87 STRATFORD LN,YARMOUTH PORT, MA 02675-1434 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: Power, lights, &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- ❑ No.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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number _ Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 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 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: BRUCE M ALBERICO Licensee: Bruce M Alberico Signature LIC.NO.: 11751 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:20 PINE ST,YARMOUTH PORT MA 026751837 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 2440 n f (2 itsee 4/(q 1 — cluit-1, 6(-ze(li f Caminoruusatrh of r�la65ac Official Use Only �� / 1JaParlmanf of.lira Jcrvrcae Permit No.��jl z- 7 Q 3 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked '.:--•�`f [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 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: `Z-I 9 1 1 City or Town of: YARMOUTH To the Inspector of Tres_ By this application the undersigned gives otice of his or her intention perform the electiticalavork described below. Location (Street&Number) C . 0 ITC- 2 r Owner or Tenant Z—p{AA) i)("/ CE Lo I ' ` qe Telephone No. Owner's Address Is this permit in con unction with a build' a 't? �A,a 1 Api ns tyN ❑ (Chtion No.:Appropriate Box) Purpose of BuildingV(trq ` �j / / `Y/' V.—Utility Authorization Existing Service Amps / Volts Overhead ❑ Undgrd gr ❑ No.of Meters New Service C) Amps `2U /ZC(Cwolts Overhead l ❑ Undgrd �No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: o1/4).,,eii` k L S )set..3 -citv tC-ls 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 Abod. �ve In- No,of 1✓mergency Lighting _rn . arnd. � Battery IInits 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 Total No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' Municipal Local❑Connection ❑ Other No.of Dryers Heating Appliances , 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 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 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 0 OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that th ' rncation on this application is true and complet FIRM NAME: I Licensee: LIC.NO.: Sigma LIC.NO.:2_= (1 (If applicable.enter "exempt"in the license number line.) Address Bus.Tel.No.: �y j Per M.G.L. c. 147,s.57-61,security work requires Department of Public SafetyAlt.Tel.No.: 75 �c OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n—o �� S required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner ❑owner's alent. Owner/Agent Signature LA Telephone No. PERMIT FEE: $