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Home My WebLink AboutBlde-21-002009 or Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-002009 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:10/16/2020 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice or his or her intention to pertorm the electrical work described below. Location(Street&Number) 12 SANDPIPER LN Owner or Tenant SERGI JOHN L Telephone No. Owner's Address 15 FIELD RD,SUDBURY, MA 01776-1106 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 foy split NC system. 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: JAMES M VENUTI Licensee: James M Venuti Signature LIC.NO.: 15798 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 JOSIAHS PATH,W BARNSTABLE MA 026681340 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 elephone No. PERMIT FEE: $50.00 .4 ‘• _ Conurnoaweal of///aeac tte Official Use Only I. . ,-7 it c� C� Permit No. i�(il- 20 r Thsparintsn/o/5ir+e Jsrvresd / I i i- ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/071 (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: /6// Z12O City or Town of: )'2 rt.Yt v ,.7--4 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) J 7 .< ciefili 1 190-- L_// Owner or Tenant o"-) + 3.--ol^►1-1 45`.-,.)1 Telephone No.Q ?-S/y-333f Owner's Address Is this permit in conjunction with a building permit? Yes 0 No E (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 Ampacity Location and Nature of Proposed Electrical Work: / A i L /tit ,'e.2.1 s ita;f- Sys/ c/, -4`.J Completion of the followin&table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.Susp.(Paddle)Fans No.of 'j otaT Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.or Emergency Lighting t rnd. 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. Tonsl No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Seft22ontained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area_leating KW Local❑ Munici1 l Connection ❑ Other No.of Dryers Heating Appliances KWSecurity Systems:* No.of Devices or Equivalent No.of Water K,,i, No.of No.of Data Wiring: Ballasts Heaters Signs 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 Me Inspector of Wires Estimated Value of Electrical Work: (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 ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [ BOND ❑ OTHER 0 (Specify:) /certify,under thins and penalties�ofperjury,that the information on this application is true and complete. FIRM NAME: �("Len,_S M . Vc..rw+:1 i I c-c-*i&-- — / - LIC. NO.: A/ S7 7 ILicensee: �;-ii s Ms Vc✓7,s1'7 Signature C=�!�`!/� `� LIC. NO.: (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.•SOT-kin=7aotS Address: 3C3 30 S i 41 S 142 -1� IAA •1✓c-,-rt$7� 1c /14 A Q 2k)6 e Alt.Tel.No.a5og-('if.-5.361' *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. 1 am the(check one)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ 7 E/4A1 L -. jVcrc-441 ' C . 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