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Home My WebLink AboutBlde-20-002693 o• Commonwealth of Official Use Only E:--,t Massachusetts Permit No. BLDE-20-002693 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:11/8/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 260 LONG POND DR Owner or Tenant ARNONE DAVID M Telephone No. \a Owner's Address ARNONE SANDRA W,260 LONG POND DR, SOUTH YARMOUTH, MA 02664 i,y Is this permit in conjunction with a building permit? Yes 0 No 0 B ) Purpose of Building Utility Authorization ,�` `y I 404 ' Existing Service Amps Volts Overhead 0 Undgrd s Ill" New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service&wire for split A/C. 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. 1 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: JOSEPH P ROSE Licensee: Joseph P Rose Signature LIC.NO.: 21335 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 Beverly Rd,West Yarmouth MA 026733559 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 0 1 f.& ( ( 1‘ 2 it 9 -6_ l..,oinnwn uea&of//laeeach..4alfe Official Use Only Q cc�� cc-'�� nn Permit No.�� l , ..._.,.., ,.._ . ,.. • ...,:z Ar:_-"! 2spart`menf o`.}irs Jervicse \n �. BOARD OF FIRE PREVENTION REGULATIONS [Rev 1//07)Occupancy and Fee Checked Zsf �``. r1 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: il ' 161 City or Town of: YARMOUTH To the Ins ct of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) \v G Y►'\ Owner or Tenant DGV G .( 0 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. �3 10 6>ss y Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: eU)C4 Lr 11 4 ,Nv \V.*C Se1- \44-4.� f>VvYNeN 4Completion of the following table may be waived by the Inspector of Wires. 'wc Total No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Tf Transformers KVA v No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingAbove In- No.of Emergency Lighting Pool 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 Tons No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Contained Totals: Detection/Alertin Devices ---- j— -`"``No,of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ t n • , �"� Rio.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent '''' No.of Water No.of No.of KW Data Wiring: Heaters Signs Ballasts Na of Devices or Equivalent c' No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: i 1 No.of Devices or Equivalent _ > OTHER: .. Attach additional detail if desired,or as required by the Inspector of Wires. t '' Estimated Value of Electrical Work: (When required by municipal policy.) s' Work to Start:IL 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify,under t e pains and en ties of perjury,that the information on this application is true and complete. FIRM NAME:e¢`i C.- 4' r, LIC.NO.: a 1332 A Licensee: _3QSe-f1 f gt5 C. Signature ri, ?- LIC.NO.1 3:kg!) Is (If applicable,ever i;}the lice number ling.) J�� Bus.Tel.No.: f�.l i 3%1 Address: . L'SG-�/t..(t V Ka ( ,y6 e yv oln 6)�� Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,s unity work requires Department ofPublic Safety" 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $