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HomeMy WebLinkAboutBlde-19-000004 r ' Commonwealth of Official Use Only attO Massachusetts Permit No. BLDE-19-000004 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:7/2/2018 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) 7 CHECKERBERRY LN Owner or Tenant ROONEY JOAN Telephone No. Owner's Address ROONEY FRANCIS A,7 CHECKERBERRY LN,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Che Appropriate Box) Purpose of Building Utility Authorization No.p Existing Service Amps Volts Overhead 0 Undgrd ters New Service Amps Volts Overhead 0 Undgrd 1V�t � Number of Feeders and Ampacity /� Location and Nature of Proposed Electrical Work: Wiring for two A/C's and motion sensor 4ra:), /,Com letion o the ollowin table h�7fts ector Wires. p .r f g p of 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 0 In- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 2 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 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: Domenic J Vitone Licensee: Domenic J Vitone Signature LIC.NO.: 13953 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:86 UNDERWOOD AVE,WEST NEWTON MA 024651024 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVEI{f 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. I PERMIT FEE:$200.00 r ']1A `t/s//! '7� r Commonwealth of Massachusetts ,. fficial Use Only �'- = Permit No. Ct —0ooi. i--� -_ S. .spar oj�,,.Services ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] . (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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 0 -«9— /8 City or Town of: y,AR1VMOUTH To the Inspector of Wires: By this application the pndersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) G n e G k e r 6 r i N, L-rJ Owner or Tenant ?c, , l L 61 1-L + J k Aro r, -ry,r(..,R j t, Telephone No. Owner's Address i A t-,f ,p .. ,A, go V‘ Is this permit in conjunction with a building permit? Yes ❑ No E (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service /U U Amps ''6/ //° Volts Overhead ©. Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity 0- 2 Z v�� U 1 5 Q r/l, c ,',- i 7&S Location and Nature of Proposed Electrical Work: i,/�,j 74,., n A L f Ie j v.n, S ;;��� Tq 1 V ono// -c„Is-, A ex / /,z 4 7i vi , ,...ice. Completion of the followin• 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 lr:mergency Lighting • d.gra _gm& Battery Units No.of Receptacle Outlets 2. No.of Oa Burners FIRE ALARMS INo.of Zones 1 No.of Switches No.of Gas Burners No.of Detection and Initiating_Devices Total No.of Ranges No.of Air Cond. Z Tons y No.of Alerting Devices No.of Waste Disposers Heat Pump Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' Municipal L0�❑Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of 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 (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 the information o is plic 'on is true and complete. FIRM NAME: V / To NE c L e 7r/( L. L C ` ,� LIC.NO.: 4)3 133 Licensee: 1/:;,,/, c I" 7�e Signatur (If applicable,enter "exempt"in the license number line.) / LIC.NO.:L s'3 L '�S Address: f3 //ra� i'-' ✓o ✓r; [,/1 : �'V��/tC /�W p •y�3- Bus.Tel Tel.No.:� /�- s .. .�Z> j *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No.� OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage ny S required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner Owner/Agent ❑owner's a eat Signature. Telephone No. PERMIT FEE: $ --_