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Home My WebLink AboutBLDE-20-006298 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-006298 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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:6/18/2020 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) 41 BAXTER AVE Owner or Tenant GALKOWSKI JEANNETTE Telephone No. Owner's Address 14 LAVENDER LN,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appro.date Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 44 .t .1„. New Service Amps Volts Overhead 0 Undgrd 0 le of ./ 9 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace three interior&4 exterior light fixtures. 484.,s Completion of the following table may be At •: e Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Transformers No.of Luminaire Outlets No.of Hot Tubs Generators �/� At No.of Luminaires Swimming Pool Above ❑ In- CINo.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/Alertine 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: JOHN M PIMENTAL Licensee: John M Pimental Signature LIC.NO.: 27968 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 1158 E FALMOUTH HWY, EAST FALMOUTH MA 025365455 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. I PERMIT FEE: $50.00 A C(z --zo K f1i,_o Kg t�oinunonweallh o/rilamacktiald Official Use Only ... ._ d cc�� n�7 - a+ 1Selpar�„en1 o`�ire Jervrcee Permit No. /�� _ BOARD OF FIRE PREVENTION REGULATIONSOc Rev. /07J s r . • 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 INFO§MATJON) Date --/7—2e2._(4______ ______ City or Town of: )'Ow-/wo✓Klj To the Inspector of Wires.- By this application the undersigned gives not' of his or her intention to perform the electrical work described below. Location(Street& Number) Li 1 f 4r—e_ Owner or Tenant S'cG�r ,�-e LVA..4 tu S h , c t Telephone No. S o f I j3 670 3 Owner's Address IN?3 t- Ye,.....v-1444 v kk il44.S f Is this permit in conjunction with a building permit? Yes No ❑ (Check A ppropriate Box) Purpose of Building Q. ../(VYri Utility Authorization No. Existing Service I ill Amps /id/ ZZd Volts Overhead Q'.---- Undgrd❑ No.of Meters New Service Amps / %'ofts Overhead❑ Undgrd dg 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: pt p -2 r lg&&e Ct,,t'h&s r,ay � o .. . ,, -e 'x'22 Co .etion o the ollow' table - • •be waived bt•the Ins• for o Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans 'o.o ota Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool ' i ve #--, n' '0.o agency R: ng d. rnd. ❑ Bette Units No.of Receptacle Outlets No.of Oil Burners al=11 No.of Zones No.of Switches No.of Gas Burgers o•o ect nan Initials_ Devices No.of Ranges No.of Air Cond. T ns No.of Alerting Devices 'eat ump `um r _ons `! `a o PI ��n_ No.of Waste Disposers Totals: ��` Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Munk:Ipa No.of Dryers Heating Appliances KSeen ty Con 0 Other KW ems: Na of i `o.0 "ater �oo , or •uivalent Heaters KW o.o Data Wiring: S'. s Ballasts No.of Devices or No.Hydromassage Bathtubs No.of Motors Total HP ns uivalent ecommun g� OTHER: No.of Devices or uivelent ' Attach additional detail ifdesired,or as required by the Inspector of Wires Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start:to/S-j.o LI 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 c,o_v,,ers is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE L'/' BOND 0 OTHER 0 (Specify:) I certh',under the pains and penalties opp jperjuq,that the infnrnratio,,n onn this application is true and complete. FIRM NAME: licensee: ,� d � ��LIC.NO.: ---________-- Licensee: "exempt"in the license mrmbe line.) Signature ,AJdY�/'� . "ri LIC.NO.: Address: ® 7'I2_ co r-C5re-V4. 4 �� U-( y y/ Bus.Tel.No.:Spys�/, S/f'7Z 'Per M.G.L.c. 147,s. 57-61security work requires Department of Public Safety"S"License: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hav Lk.No. required by law. By my signature below,I hereby waive this requirement. I am the(check one t■ ownnsuranerroVe�e normally Owner/Agent •owner's a_ml. Signature Telephone No. PERMIT FEE:$ i/())1