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Home My WebLink AboutBLDE-22-001781 Commonwealth of official Use only Massachusetts Permit No. BLDE-22-001781 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:9/28/2021 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) 65 CIRCUIT RD Owner or Tenant DIPIAZZA DAVID Telephone No. Owner's Address DIPAZZA DEBRA, 11 BERGEN AVE, HILLSDALE, NJ 07642 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: Upgrade service,water heater, &air conditioning. 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. Total No.of Alerting Devices 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 0 Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: 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 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: ADAIR MARTINS ELECTRICAN Licensee: Adair Martins Signature LIC.NO.: 55688 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:215 Palomino Drive, Barnstable Ma 02630 Alt.Tel.No.: 5088156173 *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 my 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: $75.00 k. \-/A 1 \ SEP 2 ' Commonwealth of.r/laseachuestle Official Use Only - c n Permit No..22-—V'T I t-� ' �T spartmsnl / J BUILDING U +11^ o era Serviced Occupancy and Fee Checked eY BOARD OF FIRE PREVENTION REGULATIONSj [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(;vt ,$27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: o / / (9.4 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned Oyes notice of his or her�' tention to perform the electrical work described below. Location(Street&Number) ap C4 Fall- V^U (A +-- 7 Aw.niw 741 Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a buildin permit? Yes C�No U,o ❑ (Check Appropriate Box) Purpose of Building s e.rl fA Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd No.of Meters ENew Service Amps / Volts Overhead E Undgrd n No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1 s÷ ektAsL 0(2. l,.Jc,,r►L : SQxYiCQ ('ry[Ti61 r?t R1100L.4 ken,� Ur) 4C w;r ni vlCompletion of the following�table may be waived by the Inspector of Wires. ILO No.of Recessed Luminaires No.of Ceil: Transformers KVA Susp.(Paddle)Fans Tf Total r‘,/ C=t No.of Luminaire Outlets No.of Hot Tubs Generators KVA r� k No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units J 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 III No.of Ranges No.of Air Cond. onsl No.of Alerting Devices 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 0 Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Secu of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters SignsBallasts 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 o Ele trical Work: (When required by municipal policy.) Work to Start: O a,{ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE V RAGE: Unless waived by the Dwner,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 ❑ 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::,> e >4,i r ` 'l,i,t ci,Ks yg_ Elec. C.t'e,.e, LIC.NO.: S56 ae -6 Licensee: q, ` r i T)-)As U(LSignature _ LIC.NO.: (if applicable,enter" em,�t"in the licensq number li e.) Bus.Tel.No. • Address: dr 0) G�c t�ilS p =ent a (,/( �if Q� It.Tel.No.: 'Per M.G.L.c. 147,s.57-61, curi wo requires 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 PERMIT FEE: $