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Home My WebLink AboutBLDE-22-007119 Commonwealth of Official use only Massachusetts Permit No, BLDE 22 007119 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/N INK OR TYPE ALL INFORM..!LION) Date:6/8/2022 City or Town of: YARMOUTH Tu the Inspector('I hires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 474 STATION AVE UNIT 2 Owner or Tenant April Needham Telephone No. Owner's Address 474 STATION AVE UNIT 2, 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 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Receptacle for coffee maker(UNIT#2) Completion of theJnllowing 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 0 In- ❑ No.of Emergency Lighting grnd. grd. Battery Units No.of Receptacle Outlets 1 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. 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 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 Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: _No.of Devices or Euuivalent 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. -CHECKONE: INSURANCE 0 BOND 0 OTIIER ❑ (Specify:) /certify,under the pains and penalties of'perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Romando Bennett Signature LIC.NO.: 56610 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 678 Old Strawberry Hill Road,Centerville MA 02632 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 ani aware that the License does not/rave the liability insurance enverage 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: $80.00 ` ` R C.ommotuveaK o f cc/il esaeluea tEe ofPermit No. � '71l I Official Use Only/ �j •` .Uepartmeni 4.74.Serviced.. +; Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS (Rev.iro7] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed m accordance with the Massachusetts Electrical (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: u/1M i 7 * City or Town of: `�,;�,,h ( r 0'- 'h To the pector of Wires: By this application the undersigned gives ' his or her intention to perform the electrical work described below. 4 Location(Street&Number) .47-4 4-,.ys )nj 0 0,4_ S U i Tl:l6 �' Owner or Tenant I t I egA h a -r1 Telephone No. p & 7, 5.3 t Owner's Address '- la mm Loo Is this permit in conjunction balding permit? Yes Q� No 0 (Check Appropriate Box) Purpose of Building )k'aOr Utility Authorization No. a 1 Existing Service j 50 Amps / Volts Overhead 0 Undgrd❑ No.of Meters ki New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters ._ Number of Feeders and Ampacity do ' Location and Nature of Proposed Electrical Work: Abb ( 'FEC (pryAKE . OUTLET t. Completion of thefollowingtable my be waived by the Insfiector of Wires. Lb No.of Recessed Luminaires No.of Cell. addle)Fans No.of Total t 'S� Transformers KVA c No.of Luminaire Outlets No.of Hot Tubs Generators KVA eA Above In- No.of Emergency Lighting Na of Luminaire: Swimming Pool mind. ❑ grad. ❑ Battery Units zzi No.of Reoeptade Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and � Initiating Devices IQ No.of Rouges No.of Air Cond. Tootal No.of Alerting Devices No.of Waste Disposen Heat Pump Number Tons KW No.of Self-Contained Totals: _. __ . ....- _._ .. __ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other No.ofYs Heating Appliances KW Security Systems:* DryeNo.of m or Equivalent No.of Water No.of No.of ys Ballasts Dataw Noof Heaters KW SDevices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP T Ommun ons �V y massage No.of Devices or Equivalent OTHER: Attach aa*iitunxtl detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: ft 150-DD (When required by municipal policy.) Work to Start: t -/0 -z 2. Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCEOVERAGE: 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 tke information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee:1?n1 Huila 13ennek Signature — LIC.No.:5b(oIO'f3 (If applicable,enter"exempt in the license r ie Bus.TeL No.: Address: (per 01Act`((Au ftU MI Kl UMI-MlIUUe.,MA O@lo3 - Alt TeLNo.: *Per M.G.L.c. 147,s.57-61,securi�tvy'uork 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 si nature below,I hereby waive this requirement. I am the(check one)®owner 0 owner's agent. Owner/Agent Signature Telephone No. 5"o�s 3`+7 x(433 PERMIT FEE:$ ,_ �