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HomeMy WebLinkAboutBlde-21-002033 Commonwealth of Official Use Only �E Massachusetts Permit No. BLDE-21-002033 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:10/19/2020 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) 15 LEWIS BAY BLVD Owner or Tenant POLINA GASPARIAN Telephone No. Owner's Address 15 LEWIS BAY BLVD,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appr' i its x) l/ Purpose of Building Utility Authorization No. 23 Existing Service Amps Volts Overhead 0 Undgrd 0 0 New Service Amps Volts Overhead 0 Undgrd 0 i :10) i,jl_ Number of Feeders and Ampacity ' Location and Nature of Proposed Electrical Work: Install security system&cameras. 0‘.: 4 Completion of the following table may be waived by t :4 44.'. a. Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of , 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 Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* 6 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 PALERMO Licensee: JOSEPH PALERMO Signature LIC.NO.: 7164 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 118 E CENTRAL ST, FRANKLIN MA 02038 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: $45.00 D/ / 1o(k \��a). - Commonwealth o/Ma iiachuiet Official Used my W ie-- i- t Permit No. 35 -_4— epartment o�.ire Services _�_{_ 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: 10// l do'.o City or Town of: KoYl0 To the Inspect r of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) IC Let 5 ga ' It'I Owner or Tenant (2Dit fl( vasp Wall / Telephone No.f,(�-?6,1-3 j Owner's Address Is this permit in conjunction w' h a building permit? Yes El No I�.1 (Check Appropriate Box) 5 Purpose of Building �� ije/1)�j 41 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: Can el )kereza, ' © c1z nova C Completion of the following table may be waived by the Inspector of Wires. rano INo.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 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 AlertingDevices 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 ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:*No.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: 71) / Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 3 bd (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 coverage is in force,and has exhi ited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER (Specify:) ,/'/1'A✓.."Wd I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME:AD7" LLC LAW ApT-titer• Piy LIC.NO.: -7/64 e _ Licensee: 9or.vd, e. dui..Q SignatuL ,17,(� --- LIC.NO.: '7/64 C (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:-WI-441-2-773 Address: .2rvr ,,✓,rt„f,.r._.,1..2 n/i" b./.NA....,ma Alt.Tel.No.: *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. DO 2 7Y 7 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 i� Signature Telephone No. PERMIT FEE: $ 145