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Home My WebLink AboutBLDE-22-003898 Commonwealth of Official Use Only or E` 1 \3\ Massachusetts Permit No. BLDE-22-003898 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:1/13/2022 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) 5 CADET LN Owner or Tenant LICAUSI ANGELO Telephone No. Owner's Address 11 SAINT JAMES RD, MEDFORD, MA 02155 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: Kitchen&bath remodel. 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- o 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 Inittatine Devices r. Tot No.of Ranges No.of Air Cond. Tonal 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 ❑ 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 Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: John M Messina Licensee: John M Messina Signature LIC.NO.: 12207 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 PLEASANT CT, MEDFIELD MA 020522517 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 Nt1A l 01Z-a (9szi4t( �NJ Q1Y&f( / f27Z S 14 Commonwealth o`///aeeachuaa(fe Official Use Only ' Permt No 2 7 3'( g71,1,7=,ti 3Sparimeni of give Serviced r 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 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 0/ /z, -y-L. City or Town of: YARMOUTH To the Ins ector Wires: By this application the undersigned gives notice of his or her intention to perforin the electrical work described below. Location(Street&Number) - ( JCT L Ac�v— 1 or Tenant Ae.., L-L 1 C'a 2i S 7 Telephone No. Owner's Address 5 C.kt)wir LAr-- ft"--- woo u 774 .rr Is this permit in conjunction with a building permit? Yes p No 0 (Check Appropriate Box) f J4-zz-a n z�9� Purpose of Building X17/T�2.s1->r0�. Utility Authorization No. Existing Service In C. Amps 2.4C// 1.7, Volts Overhead Undgrd g ❑ No.of Meters �_ New Service Amps / Volts Overhead ❑ Undgrd g ❑ No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: T,//,ice / € / tri `) Completion of the following�table m be waived by the Invector of Wires. No.of Recessed Luminaires No.of Cell.-Sas (Paddle)t. No.ofd Ca.-Snap. Fans SAI �; No.of Luminaire OutletsTransformers No.of Hot Tubs Z' Generators KVA No.of Luminaires SwimmingPool Above In- No.of Emergency en Lighting '�" No.of Receptacle Outlets4rnd. ❑ fid' ❑ Battery Unitsgg g - l� No.of Oil Burners FIRE ALARMS JNo.of Zones ` No.of Switches fa No.of Gas Burners No.of Detection and I No.of Ranges r Initiating Devices S / No.of Mr Cond. T°tai Tons No.of Alerting Devices No.of Waste Disposers Meat Pump Number Tons KW No.of Self-Contained Totals: ""��-___..._ Detection/Alertin, Devices No.of Dishwashers / Space/Area Heating KW Local 0 'un pa No.of Dryers Connection 0 ��' fY A / Heating Appliances KWa ty ystems: "" o.oo. No.of Devices or "uivalent o.o H�ettem KW Si_ns Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Motors Na of Devices or uivalent Total HP a ecommun a"ons " i gg OTHER: No.of Devices or E.uivalent Estimated Value of ec e��- Attach additional detail if desired,or as required by the Inspector of Wires. 1 Work: c (When required bymunicipal policy.) Work to Start:�j •Z �Z 1� Po Y) INSURANCE C VE Inspections to be requested in accordance with MEC Rule 10,and upon completion. 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 thermit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER I certify,under thepains , El 0 (Specify:) ___F;(..5 ' /�/77 P9G' Z/ lel ofperjury,that the information on this application is true and complete. FIRM NAME: .� M ir\I\(al 5,.Si,4.-,µ Licensee: LIC.NO.:/ (lfapplicab/e,enter pl in the license number line.) Signature .� � LIC.NO.: Address: 'Z t' �,`r � d Bus.TeL No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of PublicSafety"5""License: —r_ Alt.TeL No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n —" Lic.No. required by law. By my signature below,I hereby waive this requirement. I am the(check one ■ owner ■ owner's a•ent. Owner/Agent y Signature Telephone No. PERMIT FEE:$ �� r