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HomeMy WebLinkAboutBLDE-21-001827 Commonwealth of Official Use Only Iftt:07.IA Massachusetts Permit No. BLDE-21-001827 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:10/7/2020 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) 27 RUNE STONE RD Owner or Tenant PETRONE LORRAINE R Telephone No. � Owner's Address 27 RUNESTONE RD, SOUTH YARMOUTH, MA 02664-1324 l,�o) i/ Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ap �e Bo Ze Purpose of Building Utility Authorization No. O Existing Service Amps Volts Overhead 0 Undgrd 0 No. .1 e New Service Amps Volts Overhead 0 Undgrd 0 No.of - .4411) 7 Number of Feeders and Ampacity -#.Location and Nature of Proposed Electrical Work: Underground run&wire shed. O Completion of the following table may be waived by th• t,•' .f Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 'i J� Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool ove ❑ In- CINo.of Emergency Lighting Abgrnd. 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:* 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: Robert J Carreiro Licensee: Robert J Carreiro Signature LIC.NO.: 19861 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:2 RITA AVE, S YARMOUTH MA 026641976 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: $90.00 k�i Otrkutz /ofr/z -_ COrnnsonnrea 0///la.6sautc� �stis Official Use Only In- _.� , o�...7-ire t817 ? _,-„,,w,-; 2epartme f .y-ire Service9 Permit No. — BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (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: City or Town of: YARMOUTH r/G�Z o By this application the undersigned To the Inspector of Wires: im gn gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) ..17 ' ,Ne- S\'--o at.;E. Owner or Tenant „di/fee,,v /4JCTieOAu Telephone No. Owner's Address Is this permit in conjunction with a building ermit? Yes Purpose of Building �;10 / Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd IR' ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd>;r ❑ No.of Meters Number of Feeders and Ampacity Pie Location and Nature of Proposed Electrical Work: SQA 1( �N�e G.,Co u ti� ei i'c -' S�7 • , w,�� s/�l e-� ,e, Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cal.-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)mergency Lighting - mad. }rnd. 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. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number f Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal _ Connection ❑ 'er No.of Dryers Heating Appliances KV4, Security Systems:* No.of Water No.of No.of Devices or Equivalent No.of Heaters ' Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: —� No.of Devices or Equivalent eve- =' WuDerXeeto uivi -XXii/ l at-) AC.7©CA.1 t Attach additional detail if desired or as required by the Inspector of Wirer. 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND ❑ OTHER ❑ (Specify:) f certify, under the ins and penalties of perjar',that the information pn this application is true and complete. FIRM NAME: ..j. 64 eicr/ee, k , _.e t CI i1 LIC.NO.: k_�L! Licensee: �b de7Z7-7.1. 6201✓l to lea Signature (If applicable,enter"exempt"in the license number line.) �� � LIC.NO.: Addresr. Bus.Tel.No.• J Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safetyc.No.Alt Tel.No.: O— WNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage no� ..c required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner 0 owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $