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Home My WebLink AboutBLDE-21-001028 Commonwealth of Official Use Only E` Massachusetts Permit No. BLDE-21-001028 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:8/31/2020 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) 30 HARBOR RD Owner or Tenant SISKO EVELYN Telephone No. Owner's Address 666 COOPER AVE, ORADELL, NJ 07649 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 / i Number of Feeders and Ampacity i Location and Nature of Proposed Electrical Work: Rewire bedroom,fan/lights,gas stove, &dishwasher. Completion of the following table may be waived by the Inspec or of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Tota TransformersA 04 KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emerge O grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No. No.of Switches 4 No.of Gas Burners No.of Detection and 0 Initiatine Devices t 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 n Totals: J Detection/Alertine Devices �( No.of Dishwashers 1 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 Siens 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:$50.00 r14a_ ei (tf - r w eimmonweaith 4 Ma aclwdelt3 _ Official Use Only d! ' 2eparfriienf`l .� Putt No. (!2� — 245 =ii'tt a eruk o „G =1 c' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked • ccuP c3' �„.~ [Rev. U07] (IcaYe bi:mk) 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 RVP'ORMATIO.IV) Date: F-...W.- f City or Town of: X2-�,®.� To the Inspector of Wires: By this application the undersigns _'gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 3(J./ (4,.-�ie/£l) Owner or Tenant Ar- ^/`'J7Gr-c,-e/4 Jdi' , ,, , j2r,to Telephone No.4.50T 1/air • Owner's Address _14,,he Is this permit in conjunction with a building permit? _ Yes Et 'No ❑ (Check Appropriate Box) Put-pose of Building Utility Authorization No. Existeag Service Amps I Volts Overhead n Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd gr ❑ No.of Meters No uber of Feeders and Ampacity Location and Nature of Proposed Electrical Work: `� a� T,/ //�� /f, ., 1 (�� e�a-,,', 4r.6.-e��‘l i-Y-,1 ii lam- L.r�7�. r,d 4 ter- : " 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 6o.of Luminaires c ., SwinnmimgP grad- grad- Batteryunids ool Above ❑ In ❑ No.o#LrmergencyLighting 'No.of Receptacle Outlets / No.of OR Burners FIRE ALARMS No. of Zones No.of Switches' �/ No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges f4j /ye No.of Air Cond. To No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Sel -Contained Totals: Detection/Aleri ng Devices No.of Dishwashers / Space/Area Heating KW Local❑ lYhuli ail ❑ Other Conn ion No.of Dryers Heating Appliances KWSecNo urio Systems:* or Equivalent No.of seaters IOW No.of No.of Data`Dearing. Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications'Winne:— No.of Devices or Equivalent OTHER: . Attach additional detail Vdesire4 or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start. lcj j Inspections to be requested in accordance with M EC Rule 10,and upon completion. INSURANCE OVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless i 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 ND ❑ OTHER ❑ (Specify;) I certify,wider the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee:fri3O(If applicabr" in license=lam er Address: JL/ `ea ii e E i �: tZ 6 9 Bus.t TeL No.: �7/U'gy� Alt Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires i''► „u:is 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. I ER T1EJ $ -- I. i