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Home My WebLink AboutBlde-21-006406 Commonwealth of Official406 Use Only c Massachusetts Permit No. BLDE-21-006 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:5/5/2021 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) 17 LILY POND DR Owner or Tenant Carlos Gomez Telephone No. Owner's Address 17 LILY POND DR, SOUTH YARMOUTH, MA 02664-2032 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: Install generator. 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 1 KVA 14 No.of Luminaires Swimming Pool Above ❑ In- ElNo.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 ❑ 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: Frank 0 Korpela Licensee: Frank 0 Korpela Signature LIC.NO.: 34454 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 14 TROUT BROOK RD, MASHPEE MA 026492063 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:$100.00 Cgog s(.ZJ2 w r 14 Comesonu eak of Maddacktadfa Official Use /,O,it O , ., c7 Permit No. %�.—`p ` �`: ': 2)spartmsn1 o�-}iro Serviced I._;V 4 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 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 3/c)/ 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) / 1,/-lr,)OU/'= Owner or Tenant C .,-4 c V e),A7 Telephone No.(Or-s'et)- -c/ Owner's Address ✓»e Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: ///4/79 jc/Lj- lv-fe� ir. ,- nd 6' /fjs,D � air y � �o 6._ - 2 7yh. . .,1 Comp n of the following table maybe waived b r nspector of Wires. ,:_: No.of Total No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Transformers KVA Z. No.of Luminaire Outlets No.of Hot Tubs Generators / KVA Above In- No.of I•;mergemm�ting No.of Luminaires Swimming Pool grad. ❑ grad ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones and No.of Switches No.of Gas Burners -No,of Detection Initiating Devices Tot No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: - Detection/Alertb.tikpevices No.of Dishwashers Space/Area Heating KW Local❑ Connegction 0 otter No.of Dryers Heating Appliances KW No Securiof Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters ' Signs Ballasts No.of Devices or Equivalent Wiring: No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications No.of Devices or Equivalent ent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Valueeof Electrical Work: (When required by municipal policy.) Work to Start: -!'30/ 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: INSURANCEOND 0 OTHER 0 (Specify:) I certify,under the pains and nalties of peduty,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: ,Xn fz lQi Signature ,/, LIC.NO.: ? S'e (If applicable,enter e�npt"r t lice number line.) / Bus.Tel.No.:J Address: ./4///l/i , mil' y) /2 J 4 / Qa•C�l Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Dep&nent 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ 10 ,