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HomeMy WebLinkAboutBlde-20-002809 `\\( Commonwealth of Official Use Only Permit No. BLDE-20-002809 E" Massachusetts 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:11/14/2019 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 describe Blow. atiti Location(Street&Number) 5 DANBURY ST e LA l lJ I— �K-V Owner or Tenant OLIVO ANTHONY(LIFE EST) Telephone No. Owner's Address 284 ANGELL RD, LINCOLN, RI 02865 Is this permit in conjunction with a building permit? Yes ❑ 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: Septic pump&alarm. 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- CINo.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 1 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection 0 Other: 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 1 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: Robert M Scena Licensee: Robert M Scena Signature LIC.NO.: 21570 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:9 Marilyn Rd,PO BOX 43,Buzzards Bay MA 025323733 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 .411 Cs_ (1(0-l( ? ( - 4 Comnwnwsa[th e/Maadachudalta Official Use Only t.-" cc�� cc77 nn Permit No. �2c�� a `, % ,-t-,.:v,4'_/ 2)part`manl o/.}ire Serviced -• I i Occupancy and Fee Checked 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(MEC),527 CM1.12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I / // // 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 ele ttrical work described below. Location(Street&Number) 5 )7q 1,-) h L, r t / Owner or Tenant - /q / he- C e r!' v G ' elephone No. Owner's Address Is this permit in conjun tion with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building f( es / de✓> c Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead E Undgrd ❑ No.of Meters Number of Feeders and Ampadty i Location and Nature of Proposed Electrical Work: i.„1_,. / o r e i.✓ c ep-/- t G j7' ..yJp /,-2 Fa il_" a /4-/- `f - `=- Completion of the following table may be waived by the Inspector of Wires. otal `', No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transform ers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool 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 AlertingDevices g 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 al❑ 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 TelecommunicationsWinn No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Elec� rk: (When required by municipal policy.) Work to Start: / // / Inspections 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 cove is in force,and has exhibited proof of same t°°lthe permit issuing office. CHECK ONE: INSURANCE [ BOND 0 OTHER 0 (Specify:) e /tnC)1i v e I certify,under the ains and penalties of perjury,that the information on this application is true and complete. FIRM NAME:is / P v C "♦ 7 LIC.NO.: Z > y 70 Licensee: />P• $e f''f.. Signature f��-� 10 LIC.NO.:, 9c,ti o / (If applicab e,enter"exem n the license number lirn�) Bus.Tel.No. S e . Address: /? 0 /)©x y �O'S / C4'SS 6"*Y''✓4_, O a., d �AIt.TeL No.: y 5-R''7 *Per M.G.L.c. 147,s.57-61,security work 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 required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $