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Home My WebLink AboutBLDE-19-006313 Commonwealth of Official Use Only 1111,14: ' Massachusetts Permit No. BLDE-19-006313 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:5/8/2019 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) 9 SLEIGHBELL LN Owner or Tenant CORMIER PETER J Telephone No. Owner's Address CORMIER LISA B, P 0 BOX 98,WEST DENNIS, MA 02670a i ''''. Is this permit in conjunction with a building permit? Yes 0 No 0 (Cllil ` 'Purpose of Building Utility Authorization No. ' A L•_ If+ ��> Existing Service 100 Amps Volts Overhead 0 Undgrd 0 `o o teeters New Service 200 Amps Volts Overhead ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service. 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/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 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: FEBO J CICCOTELLI Licensee: Febo J Ciccotelli Signature LIC.NO.: 14707 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:324 NOTTINGHAM DR,CENTERVILLE MA 026322134 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 gii(: 1) 7 7361 l�0lril/ionw,aK h of/r/as6ac alfs ial se On �_ _ `L� (3 =� ,= c7 Permit No. =rfl_ = 2¢parfmcnt o f gipir Servr'ce9 J ` 1 Occupancy and Fee Checked :,.. ,r. 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 C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Y/ —` c/j q City or Town of: YAR1VIOUTH To the Inspector of Wires: By this application the pridersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Q' 5 i-,. 'l6,h ea fih' Owner:or Tenant ! ` . �to Co r mi it Telephone No. ( Owner's Address $L �'1 6-ti nei j '/1 1/ Is this permit in conjunction with a building permit? Yes ❑ No Y (Check Appropriate Box) Purpose of Building Utility Authorization No, (_ 33 (j 5 ?/ Existing Service /Od Amps a /do Volts Overhead D. Undgrd No,of Meters New Service qq�� Amps v� I yr) Volts Overhead / c�LL� pC ❑ Undgrd❑� No,of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: uiO (T'nt e, 5�r,GA j.e- Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cei1-Soap.(Paddle)Fans No•of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot.Tubs Generators KVA • No.of Luminaires Swimming Pool Above ❑ In- 0 No,of i;mergency Lighung - grnd.. grad, 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 Total - No.of Ranges No.of Air Cond. Tons No,of Alerting Devices Heat Pump Number Tons KW No,of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' I, ❑ Municipal Connection Other No.of Dryers Heating Appliances , Security Systems:* - No.of Devices or Equivalent No.of Water Heaters KW No.of No.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 I0,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:) I certrfy, under the pins- d penalties of perjury that the information on this application is true and complete. FIRM NAME: F I- J r C,tt Cf Offer-�i� LIC.NO.: q 6 7' Licensee: it c ,_Y >E{ ' �i� Signature S��y�y,.G b � CG-b � g � �- LIC.NO.: (If applicable,enter"exempt"in license number line.) ��f`,r� Bus.Tel.No.:. p 4�7 3 ow. Address: 3 f7 it Alt.Tel.No.: J *Per M.G.L.c. 14 s_"57-61,security wok requires Department of Public Safety"S"License: Lic.No. - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent —1 I Signature Telephone No. PERMIT FEE: $ J