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Home My WebLink AboutBLDE-21-004550 MUSIC ROOM 0.- Commonwealth of Official Use Only Permit No. BLDE-21-004550 'E�; Massachusetts , -- 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:2/11/2021 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) 517 ROUTE 28 Owner or Tenant Music Room 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 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: Install 2 recessed lights&exit sign. (MUSIC ROOM) Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 2 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators 0 id KVA No.of Luminaires Swimming Pool Above 0 In- 0 No.of E i .:y y Li grnd. grnd. Battery. _ , 4\F-2.4........_ No.of Receptacle Outlets No.of Oil Burners FIRE ALA'go fr o 4 No.of Switches No.of Gas Burners No.of Detection + Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices 0 No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 4P Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ b Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of 1 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: Richard L Serpone Licensee: Richard L Serpone Signature LIC.NO.: 6910 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 183 PINE ST,YARMOUTH PORT MA 026752374 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:$80.00 c sc9--e 0?-6-0Q_O 0-z-I 2/ , pg r-72.12, 1 St4 Common.raa 4 7114Mitchwuth Official Use Only ., • N mo. /2epa ent oph.S Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. UM] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 7 C R 12.00 (PLEASE PRINT IN INK OR TYP ALL INFORMATION) Date: vOAl City or Town of: /elp,17 — fj To the Inspector Wires: 1 iBy this application the undersign gives notice of his or intention to perform the electrical work described below. g-OwnLocation(Street&Number) ..(f)/ /*ni,Sf ,A 2g-- Owner er or Tenant bk'!oh �',or O0 ie./M&sig lirtel esti/ Telephone No. Owner's Address ,SCtprte 4S setAove v j Is this permit in conjunction with a building permit? Yes [r-No ❑ (Check Appropriate Box) .k Purpose of Building f�istyyey Utility Authorization No. C Existing Service A O O Amps olts Overhead❑ ,�UndgrdNo.of Meters I bNew Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters � Number of Feeders and Ampacity �. Location and Nature of PElectrical - �— IC . f _ , � e.x ed) s" Ytp.s—_ a:Completion of thefoiloH table may be waived by the! r of Wires. i t No.of Recessed Luminaires c No.of Cell.-Soap.(Paddle)Fans No.of eta► se Transformers KVA (l No.of Luminaire Outlets No.of Hot Tubs Generators KVA AboveIn- Ivo.of Emergency Lighting 4 No.of Luminaires ....3 Swimming Pool �d. ❑ und. ❑ Battery Units No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detectlon and s. Initiating Devices I',? No.of Ranges No.of Air Cond. Tuns No.of Alerting Devices -Contained No.of Waste Disposers Heatoottals:Pump Number Tons __-. of n/Alertina Devices No.of Dishwashers Space/Area Heating KW Local 0 Cesium 0 Other No.of Dryers H1°g AppliancesKW SecN oityf Device: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 Tel N of Devices res gga�e•nt 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: 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 covyrage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSU CE El BOND ❑ OTHER 0 (Specify:) I certify,under tinea that the information on this application is tare and complete. FIRM NAME: j e -1Qp i � w e LIC.NO.: q� Licensee: 6 Signature, LIC.NO.: A '16eSdr.,6 (If applicable,enter"erernpr in the limns;nu line.) !L Bus.Bus.Tel.No.: .foTr-3AB—S'etj f Address: /ft3 Y/ir e "r �Prom %ry /yam Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires s •/ III-1.t 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)0 owner 0 owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No. 1