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Home My WebLink Aboutblde-20-001191 Commonwealth of Official Use Only ` Massachusetts Permit No. BLDE-20-001191 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:9/3/2019 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) 15 MATTIS DR Owner or Tenant HALPERT HARRIS Telephone No. Owner's Address HALPERT ELIZABETH J, 15 MATTIS DR,YARMOUTH PORT, MA 02675 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: Lights&power. 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- CINo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones ,tl No.of Switches No.of Gas Burners No.of Detection and Initiating Devices g., 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/Alerting 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 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 ❑ 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 5it q/i (19 -I -e--- c°(q( ( g ,..• §' l-ommoruvsalth of//lassach”-twes =• Official Use Onhr ' - bltl _ 2sparfmcrr# .firs�srvicxs Permit No. (. 4 r 1 -(= = Occupncy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS (Rev. I/0a7J (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 r ,,,r,_ (PLEASE PRINT IN INK OR TYPE ALL INFORMMTTOI9 Date: I ( :z i/ City or Town of: YARMOUTH To the inspector of Wirer: I .Bf this application the vndesigned gives notice o his or her intention to rfoim a electrical work described below. n Location(Street&Number) S i" O loner or Tenant `A `1t \-- Telephone No. zOWner's Address I) ` Tis this permit in conjunction with a building ? Yes Er No 0 (Check Appropriate Box) +.��' A ^ .:,Purpose of Building Ffl \` Nyl Utility Authorization No. Existing Service l C'x' Amps l2L,/Qa E'Volts Overhead'f Undgrd❑ No.of Meters '\ New Service Amps / Volts Overhead ----- ❑ Undgrd❑ No.of Meters l� ; rininber of Feeders and Ampacity ( 3 -) lI,ocation and Nature of Proposed Electrical Work: LA. S -1— .(D ,� \,....„,. I{ -12 Completion of the following table may be waived by the Inspector of Wirer. l `" y M Lz o.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total i 0*wT ' Transformers KVA _ i z o. of Luminaire Outlets No.of Hot Tubs Generators KVA i +� =' o.of Luminaires Above In- 'No.of emergency Lighting 6-, y Swimming Pool ❑ ❑ f o -- __ , end :rnd. Battery units .of Receptacle Outlets No.of Os1 Suraers • ---'---"""'" . " 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. To No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons K No.of Self-Contained Totals:I , W Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW* MualciPal 1 Local❑Connection 0 Other No.of Dryers Heating Appliances , 'Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KWNo.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 (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 cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Sped I cerltfy, under p d penalties o 7 (Specify:) ae.g.'1 C O e .0 'that information on this application is true and couplet FIRM NAME: t ec Rt n Licensee: c LU C 1 AVQ ems` L:C. NO.: 1 licabl .enter ez t SignatureCASa C.NO.:k: Q 4 Address: n tf I?eue number line„e 2- V 6 tZ 5' Bus.Tel.No.:__ ..0 8 J "Per M.G.L.C. 147,s.57-61,security wo requires Department of Public Safety Alt.Tel.No.: _—!_ 4 — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not havethe liabilityLin.No. required by law. By my signature below,I hereby waive this requirement. I am the(check on 0 ownnercoverage notrnally Owner/Agent ❑owner's a eat. 1 .C7QT9}l7TP — - - -- I ._