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Home My WebLink AboutE-20-774 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-000774 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:8/12/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to Re' orm the electrical work described below. 1 V Location(Street&Number) 25 SACHEM PATH t T rET2.l4 j�$ Owner or Tenant PANACCIO FRANK A TR Telephone No. Owner's Address THE PANACCIO IRR TR OF 2012, 149 BELMONT ST,EVERETT, MA 02149-1443 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 ❑ 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: Replacement furnace. 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 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners 1 No.of Detection and Initiatine 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 ❑ 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjuty,that the information on this application is true and complete. FIRM NAME: Gary L Gordon Licensee: Gary L Gordon Signature LIC.NO.: 15290 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:37 BILLINGSGATE DR, DENNIS MA 026382234 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:$50.00 e (1 7\ Common wealth of//ladsachus,tt >_ Official Use Only { = cc�`� c� n T 7 aFl= 2eparinwst of..firs Jarvices Permit No. /J ® G ` f ' Ott/ _f Occupancy and Fee Checked e BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) (leave blank) (i APPLICATION FOR:PERMIT TO PERFORM ELECTR All work to be ICAL WORK performed in accordance with the Massachusetts Electrical Code(MEC,527 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9 1 el 01 City or Town of: YARMOUTH To the Inspec or of ires: By this application the undersigned gives notice of hi or her• tension to perform the electrical work described below. Location (Street&Number) qe, F- •wner or Tenant w Ca w �f e--.: f E�_ `/ G) Telephone No. •wner's Address 11.1- N c s this permit in conjunctio with a ilding permit? Yes ❑ No I' ' urpose of Building - r�0 ❑ (Check Appropriate Box) r) Utility Authorization No. LLI "4` O 'xistiag Service Cl 0 Amps LI CD 1 Z j / /,� Volts Overhead Undgrd❑ No.of Meters .Q 1.o !� w Service Amps / ' LIJ 1 F Volts Overhead Undgrd ❑ No.of Meters tuber of Feeders and Ampacity Aii fae /I 7!R� ,� m coL—�-- �l2 cation and Nature of Prop sed ectrical Work:, t6/C7 c-3 i Completion of the following;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 Swimming Pool Above ❑ In- ❑ No.oI Emergency Lighting �� grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones ONo.of Switches No.of Gas Burners No.of Detection and Initiative Devices Total Z No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number J f Tons KW No.of Self-Contained Totals: Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local D Municipal Connection ❑ Other ` . No.of Dryers Heating Appliances KW Security Systems:* No.of Water No. of No.of Devices or Equivalent No.of V Heaters ' Data Wiring: Signs Ballasts '� F No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Y Attach additional detail if desires;or as required by the Inspector of Wires. Estimated Value of7ectriga1 Work 9 S (When required by municipal policy.) O Work to Start: g /y' Inspections to be requested in accordance with MEC Rule 10,and upon completion. , INSURANCE C VE GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless il 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. Q. CHECK ONE: INSURANCE,,' BOND ❑ OTHER 0 (Specify:) ct I certify, under the pains and penalties o perjury,that the information on this application is true and complete. fP I r}5 0 FIRM NAME: �p/eip 4,d d-.SOId--r 07e t C.— �tl Licensee: LIC.NO.: o2 re) 4 rAr Signature LIC.NO.: ` (If applicable,enter"es pi"i-t :icens�number le.) 1 t • Address �ai(le n ,4.f. mg Bus.Tel.No.: __I *Per M.G.L. c. 147, s.57-61,sec YJ Alt.Tel.No.: rk requires Department of Public Safet}+'!S"License: Lic.No. — OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage n�ly required by law. By my signature below,I hereby waive this requirement I am the(check one ❑owner Owner/Agent El owner's a t Signature. Telephone No. PERMIT FEE: $ 0