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Home My WebLink AboutBlde-20-001908 Commonwealth of Official Use Only Permit No. BLDE-20-001908 Litni 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:10/8/2019 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) 797 ROUTE 28 Owner or Tenant CARON MARIE Telephone No. Owner's Address 15 TERN RD, SOUTH YARMOUTH, MA 02664 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: Wiring for addition&add sub panel. 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 ❑ 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: BRUCE M ALBERICO Licensee: Bruce M Alberico Signature LIC.NO.: 11751 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:20 PINE ST,YARMOUTH PORT MA 026751837 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$100.00 Ve—c,uati_ ( o (q 1 9 t E (VA-C- tot fc 9 i conuno►iww.Jh o////a�aclu s ,. _OtScisl Use Only • gi' - . ) nE o,. `ire Serviced : Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (xxev. 1/o7) ( — eave blank) APPLICATION FOR°PERMIT TO PERFORM ELE T (CAL WORK Al work to be performed in accordance with the Massachusetts Aectrical.Code(ME 527 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: J 0 I City or Town of: yARMOUTH To the Inspe or of Wires: By application the undersigned gives notice of his or her intention t . Location(Street&Number) 1 �.��l g °�the electrical work described below. Owner'or Tenant v�� `g ,\Jetz CA d t o a Telephone No. Owner's Address Is this permit in conjun9ti9x with a building p No? Yes Purpose of Btulding 'CX. PI �1 \ /U •❑ (Check Appropriate Box) Utility Authorization No. Existing Service 1 D C) Amps k Zc)/24,-Volts Overhead 1 1 and grd❑ No.of Meters 4 New Service Amps / Volts Overhead 0 Undgrd Number of Feeders and Ampacity 0 No.of Meters Location and Nature of Proposed Electrical Work: V c sL} l 5 Completion of the following table may be waived by the Inter o Wirer. No.of Recessed Luminaires No.of Ce1 �•(Paddle).-S addle Fans No.of Total Transformers KVA No.of Lamiaaire Outlets No.of Hot T ribs - Generators KVA No.of Luminaires Swimming Pool Ably! ❑ In- d. 0 E ry Uni cy Lighting - No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges I o� Initiates Devices • No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number l Tons xW No.of Self-Contai Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW• Local D Municipal Na.of Dryers Connection 0 �� r3' Heating Appliances , ecurity Systems:* No.of Water Na of Devices or E • Meet Heaters KW o•o o.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent k Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Wor Work to Start: (When required by municipal policy.) 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 a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) f certify, under the pains and penalties o FIRM N .f perjury,that the information on this application is true and comp! n Licensee�LJ CC r�!O� LIC.NO. ' C I S1 Signatur "� ' LIC.NO.: (If applicable,enter exempt in the license number line.) Address: Bus.TeL No.: �� J *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety Alt Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilityLin.No. � insurance coverage--- _ required by law. By my signature below,I hereby waive this requirement I am the(check one ❑owner normally Owner/Agent I Signature - ---- -- owner's