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Home My WebLink AboutBlde-19-007202 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-007202 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:6/24/2019 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) 803 ROUTE 28 Owner or Tenant TY MACK CORPORATION Telephone No. Owner's Address 803 ROUTE 28, SOUTH YARMOUTH, MA 02664 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 ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Rewire and repairs to building due to damage by pick-up. 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 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: $100.00 2-0-6)-(er "" ` � _ - Commonwealth of///addach setts Official Use Only E. c� n GRc 10 v�I-; / J Permit No. .Uaparlrnenf o erviced _-— BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 1/07] (leave blank) APPLICATION FOR:PERMIT TO PERFORM EL CT CAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 12.D0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: 6 2� '7 City or Town of: YARMOUTH To the Inspe for of Wires: By this application the pndersigned gives notice of his or her intention o perform the electrical work described below. Location (Street&Number) VoS mcNvu S * 2gr Owner or Tenant NY1firk3 E C N'AVZO A) Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Purpose of Building Box) Utility Authorization No. Existing Service Amps / Volts Overhead Q Und gird❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd tr ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Qa2s6-1 SI. QYYN!„Yit p., LD I .x-t...c..,s Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cei1.-Susp.(Paddle)Fans No.of Total Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires swimmingPool Above In- o.of i`.mergency Lighting - arnd :rnd. 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 Total No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained — Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ 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.No.of Devices or No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent — Estimated Value of Electrical Work Attach additional detail if desired or as required by the Inspector of Wires. (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule l0,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:) f certify, under the pains and penalties of perjury,that the ., . • ation on this application is true and complete, FIRM NAME: Licensee: LIC.NO.:„f� )r)S Signatu�. LIC.NO.: r= (If Address: 'clO "ez i�t�licept rrumben line.) i ' ,r 7 Addresr. `� r YY .� / • Bus.Tel.No.: 5C J "Per M.G.L.C. 147,s.1`67-b 1,security work re4tres epartr lent of Public Safety"S"License: Aft. ci�No.� - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance 5 required by law. By my signature below,I hereby waive this requirement. I am the(check one owner ce ow n� o— Owner/Agent ❑owner's a ea. it Signature 1 Telephone No. PERMIT FEE: $