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Home My WebLink AboutBLDE-22-000456 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-000456 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:7/26/2021 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) 50 LAKE RD Owner or Tenant PIACENTINI JOSEPH A SR Telephone No. Owner's Address PIACENTINI JANE, 32 FARVIEW CIR,WATERTOWN, CT 06795-1220 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: Septic pump&alarm. 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. rnd. 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. TTotal No.of Alerting Devices n No.of Waste Disposers Heat Pump Number Tons JKW No.of Self-Contained 1 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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 1 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: Rex A Burger Licensee: Rex A Burger Signature LIC.NO.: 17037 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:2045 MAIN ST, MARSTONS MLS MA 026481864 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 ' 14 Cone„ ,. atilt o`MassacLsits Official Use Only c7� cc77� �2 2 -(-0/ 6-c -, - ri CUs of tins Services Permit No. 1 B . r== -' Pa�"'sOccupancy and Fee Checked ;•• "_ BOARD OF FIRE PREVENTION REGULATIONS [Rev. (leave blank) v° APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 t .. (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 5"I,r a 3 Do& I%A I City or Town of: Ya r W1 bt.A To the Inspector of Wires: Oc." 4. By this application the undersigned gives notice of his or her intention to perform the electrical work described below. VLocation(Street&Number) 5O I..a Kt.. R91 di gest yet em t M s ► ra Owner or Tenant ?1 etC e.n i-i h ( Telephone No. ci .J Owner's Address (91 �1ov, t-1.�, 0,n. CT 2 ri o( ("L o I b Is this permit in conjunction with a building permit? Yes U No Er (Check Appropriate Box) M Authorization No. � Purpose of Building Utility IP Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters ko e New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity '▪ Location and Nature of Proposed Electrical Work: (,j 1 f T.[JI S!ns it P.sr41 a for 5.194..je, • 5 ,S`I- 044 K a i e..+. -ran ie a I art f (S b�!s•..i vt n or' bu I K kir 4.1 Completion of the followingtable m�a be waived by the lnwector of Wires. No.of Recessed Luminaires No.of Ceil.-Sri Traa onK (Paddle)Fans Trf ohl sformers VA A No.of Luminaire Outlets No.of Hot Tubs Generators KVA -- Al No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting arnd. grad. 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 No.of Alerting Devices No.of Waste Disposers Heat Pump Number Toes _ KW Detection/AlertingeSelin�ces No.of Dishwashers Space/Area Heating KW Local 0 Connection 0 Other No.of Dryers Heating Appliances KW ‘Sec * Na of of or Equivalent No.of WaterKW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNo.of Devicesro Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: l/O(.7o• oo (When required by municipal policy.) Work to Start: '7/ 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 pedm7,that the information on this application is true and complete. FIRM NAME: ge. p vis ar a.(e c'�-r"i c 4 I rinc.z LIC.NO.: Licensee: a ex, ,,(.,,(.5.1.--('5.tSignature e) LIC.NO.:,4 17 O 3 7 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.6o .3 3 1 G4'S 5-- Address: a a qs- M a,w • /Uarc f qs4 At.t'14 144- 0'A L I a 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 0 owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.