The URL can be used to link to this page

Home My WebLink AboutBlde-19-006093 o• Commonwealth of Official Use Only E.` Massachusetts Permit No. BLDE-19-006093 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•4/29/2019 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) 22 LITTLE DIPPER LN Owner or Tenant GIGGI J ROBERT TR Telephone No. Owner's Address J ROBERT GIGGI REALTY TRUST,57 JUNIPER RIDGE RD,WESTWOOD, MA 02090 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: Upgrade service&wiring for remodel. 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 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 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 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: William C Fligg Licensee: William C Fligg Signature LIC.NO.: 12584 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:55 FREEMAN RD,YARMOUTH PORT MA 026752304 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: $75.00 * Cominoruuca of 2 assachu.dafts Official Use Only 11 f---- 2epartmenf o�.�ire J Permit No. 'Lk ct _ Serviced 3 -' `� ' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked . ,[Rev. lir] (leave blank) --- APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK "" All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: L('—2jp— ' City or Town of: YARMOUTH h.,, To the Inspector of Wires: „A :-D 13y this application the undersigned gives notic f his or intention to perform the electrical work described below. Location(Street& umber) Z („_\ ) I l r Owner or Tenant cA e- , ((�c-7—t ` f- Telephone No. �K' r�rll`` Owner's Address Is this permit in conjunction with a budding permit? Yeses-- No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service (3 Amps ( tU / Z‘(‘...Volts Overhead ❑ Undgrd gr ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd gr ❑ No,of Meters Number of Feeders and Ampacity Lotion and Nature o Pro osed Electrical Work: 00 cA{U r ceO Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL 5usp.(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. rtnd. Battery Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS JNo.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 1 Number I Tons I KW No.of Self-Contained Detection/AiertingDevices Totals:I No.of Dishwashers Totals: Heating KW Local Municipal v Connection ❑ Other No.of Dryers Heating Appliances , 'Security Systems:* No.of Water No.of No.of Devices or Equiv en alt No.of Data Wiring: c5 Heaters KW 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 Vale 9f EEIctical Work Work to Start: � �`'� � (When 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 i undersigned certifies that such covers is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE e BOND OTHER ❑ (Specify) I certify, under thg pai i and penalties,f ry,that information on this application is true and complete. FIRM NAME: ` \� v--� C -`v\C 'C L LIC.NO.:\ 2S -(3 ., Licensee: 1/N\ C Signature LIC.NO.: (If applicable, enter 'exempt"in the license niAcer line.) Address: Bus.Tel.No.:Mf "Per M.G.L. c. 147,s.57-61,securi t quires work re Alt.Tel.No.: Department of Public Safety"S"License: Lic.No. 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 I Signature Telephone No. I PERMIT FEE: $ 7S—