BLDE-23-000415 Commonwealth of Official Use Only
.1-1:44"4
- Massachusetts
Permit No. BLDE-23-000415
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:7/26/2022
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) 143 STATION AVE
Owner or Tenant JANNINI EDWARD J Telephone No.
Owner's Address JANNINI RITA M, 143 STATION AVE, SOUTH YARMOUTH, MA 02664
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 ❑ 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 meter main&generator.
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 1 KVA 24
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 Switches No.of Gas Burners No.of Detection and
Initiatine 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/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local 0 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 Siens No.of Devices or Equivalent
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: Victor Palmieri
Licensee: Victor Palmieri Signature LIC.NO.: 25353
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:398 EAST ST,W BRIDGEWATER MA 023791839 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
c3' (2)7kV
Emcia /visa-Karla
1RECEIVED
i [ JUL 2 " .-f Com nonwsalh o1 Illaddachadsiid Official Use Only i
�[ ,- ��' c� c� n Permit No. - .-3—o4
_ "i d 1,� N T 1Jspartirrsni o/.}irs Serviced
BUILDING Occupancy and Fee Checked
By -- . --- ' 'ARO OF FIRE PREVENTION REGULATIONS [Rev.1/07]
(leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
MI work to be performed in accordance with the Massachusetts Electrical C.4 .TEC),527 CM) 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: IJL 2'6 `ZED'7,
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned ves notice ofhis or her intention to perform the electrical work described below.
Location(Street&Number) /1,3 5T4T) 0IV 1/45
Owner or Tenant 6-0 J A NA) 1 Ai 1 Telephone No. ,-Dg -g g 9— ‘ / gg
Owner's Address J/3 5 TAT 6 n/ A L' �� -
Is this permit in conjunction with a b �° S3 No (Check Ap roate Box)
Purpose of Building 1 f- m/ jam(/ LLLac/ Utility Autborization No. Y -3 1 7 t
Existing Service'24.10 Amps /�/2g0 Volts Overhead LZ" Undgrd 0 No.of Meters
New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters
Number of Feeders and Ampadty
Location and Nature of Proposed Electrical Work: 1j7 J./1 y /r\_ y,/j;,q i A"
t 1T'-^-1) )3y 4tV _
ConrpleHon ofthefollowtng krble may be waiverd by the/npector of Wires.
tin No.of Recessed Luminaires No.of Cell-Snsp..(Paddle)Fans o.of Total Transformers KVA
el _
c•-.1 No.of Luminaire Outlets No.of Hot Tubs Generators i
KVA 2
No.of Luminaires gmg P.A Above ❑ In- ❑ lvo.of Emergey Lighting
Enid. ernd. 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
Ill No.of Ranges No.oo Air Cond. Total ons No.of Alerting Devices
No.of Waste DisposersHatt Pump Number(Tons (ON No.of Self-Contained
Totals: I I --- Detection/Alerting,Devices
No.of Dishwashers Space/Area Heating KW Local❑ Man
Connedbn 0 Other
No.of Dryers Heating Appliances KWa ofgevi or Equivalent
No.of Mets KW No.of No.of Data Wiring:
Signs Ballasts No.of Devi or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Te onauDevices or iP:q'uiva eat
OTHER:
Attach additional detail IIf desired,oras required by the Inspector of Wires.
Estimated Value of Electrical Work: '3U (When required by municipal policy.)
Work to Start 7' 7 6 - Viz,- 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 ins including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such covers in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specifjr:)
I certijjt,ander the pair/and, naliea of, sysay the,inforniation on this application trite and complete J
FIRM NAME: 1 / ` rl ei i' LIC.NO.:62i,..3) .
Licensee: V Gr 'c 1f,4 Y1 Signature �;-�I 2 LIC.NO.:
(If applicable.enter" "in the license number line // y�� Bus.TeL No.:.'�D 01/S
Address: -3 9 6-A 57 s we s/ i/9 e z'7i,� /r� Alt.TeL No.: 31
*Per M.G.L.c. 147,s.57-61,security work requires Department of Pt blic 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 agent.
Owner/Agent I
Signature Telephone No. I PERMIT FEE:$ .re) -`