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Home My WebLink AboutBLDE-22-005437 or Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-005437 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:3/29/2022 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) 59 CAPT STANLEY RD Owner or Tenant MONTANI FRANK L Telephone No. Owner's Address 59 CAPT STANLEY RD, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 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. 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 ElIn- ElNo.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. Ton l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW. No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of DryersHeating 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: JOSEPH P ROSE Licensee: Joseph P Rose Signature LIC.NO.: 21335 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 Beverly Rd,West Yarmouth MA 026733559 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 A r3/ °( ' .�- w AA�� y/�yjj Commonwealth.of//lamachuaatie Official Use Only "_-_'Al ,.. M sPartms Permit No. &? -i."-",C14. 7 _ nt°nine Sorvicsd t`I;, = 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: "3 ( A1 a City or Town of: YARMOUTH this application the undersigned his or her int ntion to perform the electricalTo the ltdpecto of Wires: Location(Street&Number) q i 4 `t work describe below. Owner or Tenant �j(�,n� �a�.�,.0 "��n Lv � � `'' y f""� � �'1 Telephone No.' 2262 I 1 1 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service i o v Amps I�U /,L)I) Volts Overhead:0 Undgrd Undg ❑ No.of Meters 1 1 New Service Amps / Volts Overhead ❑ Undgrd 0 No.of Meters Number of Feeders and Ampaclty CLocation and Nature of Proposed Electrical Work: 'cry 1 P 4 U.pGrjL 'f v Completion of the following table may be waived by the Inspector of Wires, Li No.of Recessed Luminaires No.of Ceil.-Sus . No.o ^•! p (Paddle)Fans Total No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA t'` No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting - grnd. grnd. ❑ Battery Units "-.? No.of Receptacle Outlets p No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners 'No.of Detection and i No.of Ranges Initiating Devices No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump 1 Number T'!ons ICW No.of Self-Contained Totals: ( )_ Detection/Alerthi Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal No.of Dryers Connection ❑ Other iY Heating Appliances KW Security Systems:4 �' No.of Water , No.of No.of Devices or Equivalent Heaters No.of 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 Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work toted art:Val (When required by municipal policy.) 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* BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete FIRM NAME: Licensee: S 4p « LIC.NO.:.�>'3_ 12111 (If applicable,enter exempt"in the license number line.) Signature LIC.NO.:/ Address: Bus.Tel.No.: *Per M.G.L.a 147,s.57-61,security work requires Department of Public Safety"S"License: AIL Tel.No..; /�� C OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n�— required by law. By my signature below,I hereby waive this requirement. I am the(check one Owner/Agent ■ owner 10 owner's a:ent. Signature Telephone No. PERMIT FEE:$