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Home My WebLink AboutBLDE-22-005793 Commonwealth of a•.V O fficial Use Only Massachusetts Permit No. BLDE-22-005793 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 LEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:4/11/2022 City or Town of: YARMOUTH To the Inspector of Wires: this application the undersigned gives notice of his or her intention to perform the electrical work described below. ication(Street&Number) 22 ANTLERS RD wner or Tenant WARREN ROBERT M Telephone No. wner's Address 22 ANTLERS RD, SOUTH YARMOUTH, MA 02664 this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) urpose of Building Utility Authorization No. xisting Service 200 Amps 120/24( Volts Overhead 0 Undgrd 0 No.of Meters lew Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters lumber of Feeders and Ampacity ,ocation and Nature of Proposed Electrical Work: Installation of 200 Amp service upgrade to replace damaged service. Installation of •-4"Led lights and 2-Dedicated Circuits 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 grad. 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. TotaloNo.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 ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent 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. �j S(l� CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) e I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: COTTI JOHNSON HVAC Licensee: Jason Mienscow Signature LIC.NO.: 22630 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:36 Torrey Road,Cumberland RI 02864 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: $75.00 / -e fl /4vr ConunonweaAL o f M:l46aCIUt.44dtd Official Use Only j� , ►�__" I t c� cc�� n Permit No. E 2.0z2..--- /- (7 3 E'-1:4L .2epartment ol1 ire Serviced Tc------ " Occupancy and Fee Checked r,,,- -- ' BOARD OF FIRE PREVENTION REGULATIONS [Revsr isl- . 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: 9 7/242 City or Town of: I w „ To the Inspector of Wires: By this application the undersigned gives nott a of his or er intention to perform the electrical work described below. Location(Street&Number) 22 Amer R Owner or Tenant I Telephone No.7S1 82)-2? Owner's Address Is this permit in conjunctionw th bu lding permit? Yes ❑ No / (Check Appropriate Box) Purpose of Building gp4l' q' /¢( Utility Authorization No. Existing Service OAU Amps )a() I 2,4OVolts Overhead kl Undgrd❑ No.of Meters / New Service 200 Amps 12,U/ A40 Volts Overhead ki Undgrd❑ No.of Meters I Number of Feeders and Ampacity Location and 74ature of Iroposed Electrical Work: ilzi ll `n a,vi p dery Len Tv-de fr iace d.G.vvutt e/ cet't; �✓I -l--l( }v 1A 4 (.c.t9 1,41-5aryl /. l irol t'f? ti Completion of the followirfgtable may be waived by the Inspector of Wires._ tal No.of Recessed Luminaires No.of Ceil:Susp•(Paddle FansTof) 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 Detection and No.of Switches No.of Gas Burners 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 r--1 Municipal ❑ �� Connection No.of Dryers Heating Appliances KW Security Systems:'k No.of Devices or Equivalent No.of WaterKu, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirin : No.of Devices or Equivalent OTHER: l l , , , Estimated Value of Ele trical Work: Attach additional detail if desired,or as required by the Inspector of Wires. (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C E GE: 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: Cotti Johnson LIC.NO.:22630-A Licensee: Jason Mienscow Signature /ZZ.,,,_ LIC.NO.:12025-B (Ifapplicable,enter"exempt"in the license number line.) /' Bus.TeL No.•774-501-3041 Address: 30 Waverly Street,Taunton,MA.02780 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,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 normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's a ent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ 7