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Home My WebLink AboutBLDE-19-003277 Commonwealth of Official Use Only ((t . Massachusetts Permit No. BLDE-19-003277 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:11/29/2018 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) 52 SEMINOLE DR Owner or Tenant ROMANO BERNADETTE A Telephone No. >, Owner's Address ROMANO ROBERT T,22 REDWOOD RD, NEW HYDE PARK, NY 11040 , j / Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) ) ' Purpose of Building Utility Authorization No. . ,' 6 V C`"T Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 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 0 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. „4 FIRM NAME: TYLER W PAYNE Licensee: Tyler W Payne Signature LIC.NO.: 53024 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:5 JANS PATH, HARWICH MA 026452458 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 gt. 2Uh a c1/.z f/t r-- `vl 11- e(2'7(« 17 • • Commonwealth of Massachusetts Official Use Only 1 :ilil'_ / Permit No. act' 3 Z77 Department of Fire Services I6 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked �;,,�� I Rev.9/O51 (leave blank) cbo APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code MEC), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFOORMATION) Date: I to _-� City or Town of: �,YYN(\ �n '„� To the Ins ector f Wires: �— By this application the undersig ed g''6yvi es notice of his or her intention to perform the electrical work described below. `-- Location(Street&Number) 2 in lei D _.. Owner or Tenant g[,4 tki..1.Z Telephone No. Owner's Address 0 Is this permit in conj ction with a building permit? Yes,,,- No ❑ (Check Appropriate Box) Purpose of Building it1-t I I(nt Utility Authorization No. `� Existing Service ' p•PN Amps / •2-/olts Overhead/ Undgrd❑ No.of Meters v New Service 1)41 Amps f / 2j /OVolts Overhead❑ Undgrdyi No.of Meters I Number of Feeders and Ampacity C Location and Nature of Proposed Electrical Work: L Completion of the following table may he waived by the Inssvector 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 SwimmingAbove In- No.of Emergency Lighting Pool grnd. ❑ grnd. ❑ Battery_Umts d 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 Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices ., _�,_,_--_.._m l�io.of Dishwashers Space/Area Heating KW Local ElMunicipal Connection ❑ Other• HeatingAppliances Security Systems:* y.t,► _ 14o.of Dryers pp Kam' No.of D q �1 ' .fir, ``. No.of Water No.of No.of Devices or Equivalent KW Data Wiring: CO ,, I -.a Heaters Signs Ballasts No.of Devices or Eqquivalent r P4o.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: s E - No.of Devices or Equivalent *HER: ' Attach additional detail if desired,or as required by the Inspector of Wires. C�\l Estimated Value o Ele rical Work: �j� (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. "` """" INSURANCE C V AGE: 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 0 (Specify:) I certify,under the pains and penblties of perjury,that the information on this application is true and complete. FIRM NAME:PM ME £L fl IC1 (fIC. LIC.NO.6507, Licensee:"pi L. IN, PkYl,4e Signature _/ Y V t t LIC.NO.: (If applicabl enter"efem t"in the license number line.) ' Bus.Tel.No:T1 .209.3b Address: ` F `Tl`t ffistieW K C Alt.Tel.No.:77 4 212• F3c12. *Security System Contractor License required for this work;if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my 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:$-. * `t 7&