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Home My WebLink AboutBLDE-22-001447 Commonwealth of Official Use Only , Massachusetts Permit No. BLDE-22-001447 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•9/14/2021 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) 40 BENJAMIN WAY Owner or Tenant GLAZIER DOUGLAS C JR Telephone No. Owner's Address GLAZIER JANE H, 20 COLELLA FARM ROAD, HOPKINTON, MA 01748 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: Take over job.Walk through to see where the other electrician left off. 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- 1:1No.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 ❑ 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 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 perjuty,that the information on this application is true and complete. FIRM NAME: Daniel E Dicesare Licensee: Daniel E Dicesare Signature LIC.NO.: 21275 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:66 ELK RUN, MIDDLEBORO MA 023463065 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 _. , . ... ...t....\ , Coptdaw4ig2a..4(2.0.1 I hw.a.r.jue.4aai Oficial Use Only 1 : Zepaiftsni91...,--ws Occupancy ar:d Fe.-e C..7h=lo.. ..> ,.- BOARD OF FOE PREVENT ON RE.GLILATICNS l''R ,,., 1-,,, L'. -• '-'" I :leave ...k) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK .c work to be pecftmed is acceremce with:he Massed:use=Blectr1=1 Code(MC).577 CMR.1200 (PLEASE pizi:AiT IN INK OR TYPE ALT LVFC,R1:14,70.,\2 Date: Clii01,-2U.)i City or Town of: : \iarr1lou+11 To the Insp c to r of Wires: -1.--: By this application the midersigned gives nonce or his or her titerition to::ker13711 the electrical work described below. ,., Location(Street&Number) '-1‘..) hen Cr in R°col Owner or Tenant 000 G LoS GLAi.leir Telephone No. Owner's Address - O Boil amo 'toad I Vornoui-h ..AAA 1 Is this permit in conjunction with a building permit? N..... . . . No . . (Check Appropriate Box) Purpose of Building TV Authorizathon No. • ---- Existing Service .Amps i Volts Overhead: UndErd' No.of Meters — New Service Am ___:. ps Volts Overhead Undgrd: ; No.of Meters Number of Feeders and Ampacity _ Location and Nature of Proposed Electrical Work: es a, , it ... ."itst ) 4 -" \YvCr c-CAt( tt) ei 1161-1 1,0‘1 al Cuto-ffl el e`,1 Ccrt-riCi 0,1 Sfe 4 f 4, Comrderion of:he oileswing:able may be wthei by the IlLSPeCZOT qf P./ s o. N !No.of 'fatal • of Recessed Laminstres i No.of Ca.1.-S4–, p.(Paddle)Fans - ,Transformers KVA No.of Luminaire Outlets !No.of Hot Tubs Generators KIIA Above – In- r--. :No.at h. mergency 1.q.ltuig }No.of Lu.odinaires S . . g Pool smd ._.! .,,n.a. __, :.....et___.T-........ ;Egg cr't ."'-"' !No.of Receptacle Outlets 1 No.of Oil Barters IFTRE ALARMS 11No.of Zones 1N-o.of-Detection and No.of Switches . No.of Gas Burners initn–ming Devices Total ' :No.of Ranges IN°.of Air Cond.. 'No.of Alertb3g,Devices Tons ilieat Ninap Number 'Tons :KW No.of Self-Contabied !No.of"IN7aste Disposers Totals: Detection/AIerdn Devices ,---; Municipal 7--, No.of Dishwashers Space/Area Elea-tag KW Local[--1 Connection T. Other ; ectarst :ems w :No.of Dryers Heating Applianc . KW No.of DeViCeS or Equivalent No.of'WaterW No.; of No.of ICDam Wiring: Heaters ' Sieas Ballasts No.of Devices or Equivalent – No.Hydromassage Bathtubs No.of Motors Total HP t elecommunicationi Wiring: No.of Devices or Eduivilent !OTHER: „...::•,.. 0?,..,,2 a-erall if desi.,=, 0.--as recafr.ed 3:,..the.Tr.speczor of w:..---zs F...sriznaxed Value of Elecnice-1 Work: ;-..--rhen:7f:quire:I by mtmict-al poy.: rvcrk to Start Inspectors:o be recested in Lc:cr.:lance withC Rule IC,and u.poz ccrap:ericr.. INSURANCE COVERAGE: .:1-..less waived icy-:lr.e cyc,-_-...er,:-..o permi7.for f:..ie pe:13=2race..3felecr-:. ..1 work,7.2\ iss...ie ti: ss the licensee provides proof of liability illSZitt.:=iz.cludil....-z'completed cpezaton"coverage or its su'rs=tial ed,!..:rvalent. The mdersiped cc:ft-es that such cov--fw.g.-e is in force,and has exhibited:::mof of s ...e..:c:he 7)=111 issuing office. CCK ONE: INSLTRANCF.l 7 BONT`.. 7 OTHER 7 (s?=ify:) I cenift,under the aixts andpenatdas qf perpery,O.=the infornum:ozz on this applicsaion is true and coiripi .e. FIRM NAME: I 0_,._ ) e_ce., 7,-r If C 3 LIC.NO.:d 143754- Licensee: F;i2,/,:%((... -6; 1 ,1(.7.26A4--...-; Signarare ,"--,:= _ If :- LIC.NO.:,457(,SR E -.7f.I.ppli- bie,enter "camor"1)),the ftense=Tiber lie) Bus.Tel.No.:1211 edit fi7012 Address: L. ELe o..") M i&Cr-it> rr•-• ,4-1/A .,...-.::..2_3Y‘.1 _Alt.Tei.No.: *Per M.G.L.c. 147,s.57-61,Isecu.rity work requires Dep=en:cf?r2ciic Safari ce- e Lio.No. t''')t 3--)3 OWNER'S LNSLTRA.NCE WAIVER: I am aware that foe L-icensee ober 71:ot ha-ie.ft*liability 4;i3,1rance c,'.4.,^veza.ge nOrmall:, required by law. By my sigire.below,:hereby-..va.f.\,e.:Ills ren:uire:hent. T.a=the(check one:L.,owner L.:OW.7..'er'S ager.L. 1 OvraeriAgent i Teleohone No. PERMIT FEE: S Signature ;