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Home My WebLink AboutBLDE-22-002334 Commonwealth of Official Use Only 'At Massachusetts Permit No. BLDE-22-002334 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:10/22/2021 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) 37 PEREGRINE LN Owner or Tenant MARK AND TRACY SIMONELLI TRUST Telephone No. Owner's Address P 0 BOX 285, BROOKFIELD, MA 01506 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: 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 14 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 Eauivalent 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 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: KUNG-PO TANG Licensee: Kung-Po Tang Signature LIC.NO.: 21928 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:518 COTUIT RD, MASHPEE MA 026492351 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 RECEIVED , OCT 2 2 2021 'nwaa[th I ///aadachu4efle Official Use Only Permit No. 62-2- 34 4- t 41:=:' .1NG DEPARTME ‘'"tint o`are Occupancy and Fee Checked --C. : ' PREVENTION REGULATIONS [Rev. 1/07] (leave blank) b APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK A All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.1)0 a3 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / d —2 2- 2 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives no'cc of his or her intention to perform the electrical work described below. Location(Street&Number) 3 7 eYt.,25 it Lc .z' Owner or Tenant /) 7770 //). Telephone No. Th" Owner's Address Qs l Is this permit in conjunction with a building perm t? Yes ❑ No � "' (Check Appropriate Box) ! Purpose of Building de-r1"tc c- ( Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters • New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampadty r E Location and Nature of Proposed Electrical Work: Gj.e,. � ;ti Completion of thefollowingtable may be waived by the InssDector of Wires. ti,, No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans No.of Tota[ r, Transformers KVA '•:.t No.of Luminaire Outlets No.of Hot Tubs Generators ( KVA J7; No.of Luminaires Swimming Pool_ grnd.Above ❑ In- No.of It mergency Lighting zrnd. ❑ Battery Units ,;' No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones , No.of Switches No.of Gas Burners i.o7Detection and Initiating Devices ' No.of Ranges Total g No.of Air Cond. Tons 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❑ Monnectiounieipaln 0 Other C No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent 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: /L)--2._I -2-1 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 cov rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [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: LIC.NO.: 2-1 92_.e51--/-4 Licensee: /AV Signature—`"-__-.---- LIC.NO.: S 2_2. ' -j' (If applicable.ent ;_ pt"in th license u.>-r ine.) Bus.TeL No.. - -7f 06 Address: U mit /VA . 1 s, I • ' de=E4' Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department o'Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does trot 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 Signature Telephone No. ( PERMIT FEE:$