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Home My WebLink AboutBlde-20-000648 Commonwealth of Official Use Only .4.1410 Massachusetts Permit No. BLDE-20-000648 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:8/5/2019 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) 126 BREEZY POINT RD Owner or Tenant TAGLIAVINI DAVID Telephone No. Owner's Address TAGLIAVINI LYNDA B, 149 PROSPECT ST, SUFFIELD,CT 06078 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: Wiring for garage&sunroom. 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 ynd. 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 ❑ 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: Michael D Hollister Licensee: Michael D Hollister Signature LIC.NO.: 10071 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:85 N DENNIS RD,S YARMOUTH MA 026641017 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 L.,e,„ (thug r___ hwI (%de Cromenor wsatth of t//a.66acku-saki • cial Use Only ' cam, cc�7 n `c 3 '• �i ..UcparE„:ant i.ti,,.J Permit No. ('J� 0 tl_ F. ' ° Serviced BOARD OF FIRE PREVENTION REGULATIONS Occupancyv. 1/07and Fee Cnecked (leave blank)k) �----- APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK --�-w All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 w p-r- !.J, "LEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: c� Q City or Town of: y �/jOUTI3 �� 9 a To the Inspector of rres: „ ;w B this application the umdersigned gives notice of his or her intention to perform the electrical work described below. W `�r. ° L,cation(Street&Number) 1 2 Co 3 E Fl 0 Z � -• �er ot-Tenant ��D W i v ° Ti4•!-43 L../d-f>// iV/' Telephone No, t`j 3 ( 116/3 (� el..'er's Address 'Li s permit in conjunction with a building g permit? Yes A No 0 (Check Appropriate Box) Purpose of Building effiXt Pt4-y- &- Utility Authorization No. Existing Service Amps / Volts Overhead ❑. Undgrd❑ No.of Meters New Service Amps / Volts Overhead Elnd U d gr ❑ No.of Meters Number of Feeders and Ampacity ,C)1, � (� /'/ sq rIn 4�0 sv 41 Location and Nature of Proposed Electrical Work: �� f-4-Ca-e�� W B r�-z�T'S V Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cet1.-S addle Fans No.of Total --NI �'� ) Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA - No.of Luminaires Swimming pool Above ❑ In- ❑ "No.of lmergency Lighting ornd. aril& _Battery Units No.of Receptacle Outlets No.of Ott Burners FIRE ALARMS 1No.of Zones • No.of Switches No.of Gas Burners • Total . No.of Detection and N.„. Initiating Devices No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump [Number I Tons I KW 'No.of Self ontained Totals:I Detection/Alerting_Devices No.of Dishwashers Space/Area Heating ICW Loral❑ Municipal Connection 0 Other . Q No.of Dryers Heating Appliances , ^Security Systems:* KNo.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring Signs Ballasts No.of Devices or Equivalent `Z 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. V Estimated Value of Electri al Work: ?/0/0 (When required by municipal policy.) (� Work to Start: e t / Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VERAGE: 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:) 0 I certify, under the pains and penalties of perjury,that the information on this application is true and complete. • FIRM NAME: “A.vtiALLI S LIC.NO.: 7 �/ Licensee: iiii k ic_/s.... (If applicable,en Signature LIC.NO.: t'in the license number line.) . Address: �S- /V;� ce S Z „` Bus.Tel.No.: j "Per M.G.L. c. 147,s.57-61,secuti work requires Departtnent of Public Safety"S"License: Alt.Lic.No. ,z OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability S required bylaw. Bymysignature � insurance coverage n— or�a(ly gnature below,I hereby waive this requirement. I am the(check one 0 owner 0 owner's a eat. Owner/Agent Signature Telephone No. PERMIT FEE: S 5