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Home My WebLink AboutBLDE-22-0030191 (j OF t . ��,r ommonwealth o Official Use Only f _ Massachusetts Permit No. BLDE-22-003191 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:12/6/2021 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) 5 DANBURY ST Owner or Tenant Joe Cervone Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service&add receptacle for dehumidifier. 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 1 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 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: JOSHUA B DEJOIE Licensee: Joshua B Dejoie Signature LIC.NO.: 53490 (if applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 10 LEXINGTON LN,YARMOUTH PORT MA 026752437 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 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: $50.00 -- Np t( zv1i1 / ) (14 Ze c ..41�11,4 �_,:, - itl{IZA . 6_2: tSpr t LI ) biL) r ply , r r V ', P. n r _ ` 2 °. a` r�� < � �CL � ;..� Cornmonwea[th o�///aeeaeliueef!fe Official Use Only i Permit No. zz —3 l`l i ! c.11' c� �J 1 r •MI a« S ..Uepartmen1 o�•}ire Sorvicee t Bus Y , ' I I y Occupancy and Fee Checked ' 'S4 BOARD OF FIRE PREVENTION REGULATIONS Rev. I/0777 � 1 ()cave 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: �1-a--c).,‘ City or Town of: YARMOUTH To the Inspector of Wires: •u By this application the undersigned gives notice of his or her intention to perform the electrical work described below.6� J 1Location(Street&Number) �1buC.`' 1 Owner or Tenant as e C e.c V(AA& ) Telephone No. 110 13751 119 S `] jOwner's Address 5- b,\, cy S} °' Is thispermit in conjunction withsebuildinpermit? Yes f al j g ❑ No ►.� (Check Appropriate Box) Purpose of Building 0 u Q i\'c Utility Authorization No. �( Existing Service f DO Amps / Volts Overhead❑ Undgrd❑ No.of Meters ., New Service )Dl] Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: A e� I R0 ek 5 v .�� o , \v y Tod / c��\1J��c� b6-5(.V'l ( O J tr' Completion of the following_table m be waived by the Inspector of Wires. No.off 'I otal III No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA of No.of Luminaire Outlets No.of Hot Tubs Generators KVA r:.:t No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting �rnd. Rrnd. 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 Number Tons KW 'No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Secu of Devices or Equivalent No.of Water Heaters KW No.of No.of Data Wiring: 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: (:)A 40 (When required by municipal policy.) Work to Start: )1-1-4.\ 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 is. BOND ❑ OTHER 0 (Specify:) I certify,under the pains and"Tallies perjury,that the information on this application is true and complete. FIRM NAME: �031v c. c J E\e.etc,k.,i LIC.NO.: Licensee: . St�‘1G. b( )' E. Signature G��,.' le____. LIC.NO.: 33'1 B (!f applicable,e�erCecxem� �t!�!oi`c\ens`nutgb�line.) f' Bus.Tel.No.• Address: t S - Alt.Tel.No.: TN`fl'-f Ot•t *Per M.G.L.c. 147,s. 7-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage nonnally 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. I PERMIT FEE: $