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Home My WebLink AboutBLDE-20-000720 Commonwealth of Official Use Only tit% Massachusetts Permit No. BLDE-20-000720 ,*;.$07, 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:8/7/2019 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) 22 HARVARD ST Owner or Tenant CALLINI JOHN A Telephone No. Owner's Address CALLINI JOAN E,40 LINE ST, SOUTHAMPTON, MA 01073 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: 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 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 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 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: SHAWN A SOUZA Licensee: Shawn A Souza Signature LIC.NO.: 39768 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:31 LAKE DR, PLYMOUTH MA 023605648 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 4,4 618 ([9 we‘ ceb rL� 014(6 w-- b S Jt,(4 r o 6z.6 619 C3 _ Commonwealth o�//1a44ach ,it Official Use Only '■ -__ _____,/ Permit No. '- 07 m� _ J � __1j_ ,' ' �aParfmartt o{,emirs Jarvicel - - BOARD OF ARE PREVENTION REGULATIONS Occupancy and Fee ankcked ZRev. i/07] (leave blank) N APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK Q ca Ell--J zAll work to be performed in accordance with the Massachusetts Electrical Code(�C),527 CMR 12.00 LU LEASE PRINT 1N INK OR TYPE ALL AVFORMATION) Date: Y' 7� /®,t`Ri tr City or Town of: YARMOUTH ga this application the ersi ed es To the Inspector of�ires: 0 '® U w t gn gives notice of his or her intention to perform the electrical work described below. Liu N. 1 o ,cation (Street&Number) D.Q, fkftvct.i. .-ri -- SI Ve z�u�4 O = iz er or Tenant J0L,v GO.` \&N, Telephone No. LIJ I° er's Address Sokit. t-..- m 11 this permit in conjunction with a building permit? Yes ❑ No Check Appropriate Box) 1 Purpose of Building S%- t t iV7 l 1 I' Utility Authorization No. Existing Service AnIps / Volts Overh d ❑ Und d gr ❑ No.of Meters New Service Amps / Volts Overhead E Undg rd ❑ No.of Meters Number of Feeders and Aznpacity Location and Nature of Proposed Electrical Work: w 1 ICe vO, PO 2 el_ L- )eAick-C,< Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Col-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Laminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In_ No.of Emergency Lighting stud. ❑ BatterT units No.of Receptacle Outlets No.of OR Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiat rig Devices No.of Ranges Total r Na of Air Cond. Tons No.of Alerting Devices 3 No.of Waste Disposers Totals:• Hea P mp I Number j Tons I KW No.of Self-Contained - 1 I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Loral❑ Municipal � Connection 0 Other No.of Dryers Heating Appliances r SecNo. Systems;* No.of Water No.of Devices or Equivalent Heaters No.ofData Wiring: (� KW No.of _ A) Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - OTHER: No.of Devices or Equivalent Attach additional detail if derirecj or as required by the Inspector of Wires. 4Estimated Valu f lec 'cal Wore Work to Start: / (When required by municipal policy.) INSURANCE COVE G Inspections to be requested in accordance with MEC Rule 10,and upon completion. Unless waived the owner,no permit for the performance of electrical work may issue unless i the licensee provides proof of liability in ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) -) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: tA- �E:-5 LIC.NO.: Licensee: Sos 7- Signatu (Ifapplicabl enter"exempt"in the f' erase number fine. LIC.NO.:, _ Address f lf.Z (�, �` e /L 'AA o 'fC, Bus.TeL No.:��7'�-y y6 98 ,j "Per M.G.L. c. 147,s.57-61,security work requires Department of Public SafetyLicense: Alt.Tel.No.: - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilityLin.No. � insurance coverage no�" required by law. By my signature below,I hereby waive this requirement. 1 am the(check one ❑owner ❑owner's a eat. Owner/Agent Signature J t�� Telephone No. PERMIT FEE: $