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Home My WebLink AboutBLDE-22-000194 '�,�� \ Commonwealth of Official Use Only > E. ; Massachusetts Permit No. BLDE-22-000194 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:7/13/2021 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) 3 CHARLES ST '7 74- t e- Owner or Tenant Al Cutts Telephone No. Owner's Address 3 CHARLES ST, SOUTH YARMOUTH, MA 02664-3103 Is this permit in conjunction with a building permit? Yes ❑ 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: Install receptacles for washer/dryer. Install WP receptacle. 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. 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 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 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 O OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: JOHN B RAIMO Licensee: John B Raimo Signature LIC.NO.: 18352 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:71 NEARMEADOWS RD,WEST YARMOUTH MA 026735009 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: $75.00 is 7(t3(U o . a .,( 9/ 64(ct ju @- RECEIVED -c , JUL 12 2021 .) 1:114 uo oaf y�j�adaacl'iud/ of/t/ aife Official Use Only �:. — =>i< "� DING UEPARTM�';► { c'7 {� Permit No. z—O� ot ail';..,.,. 1 P ni of ire Serviced CJ . :'' BOARD OF FIRE.PREVENTION REGULATIONS---------- Occupancy 1/07] and Fee Checkedn ) [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance withthe Massachusetts Electrical Code(ME ),527 CMR 12.00 lCity (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7 fa ' - or Town of: YARMOUTH To the Inspe tor of ir`: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 3 CLca,i Sf Sou+ -L r rf. ve O Owner or Tenant ` 40,lcphone No. 774-- d.i,yr_ (IL , Owner's Address "� Is this permit in conjunction with a building permit? Yes No 0 (Check Appropriate Box) 0 Purpose of Building L� ___,1_•\ `Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters r LNew Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity I Location and Nature of Proposed Electrical Work: _ %._. W``- a . • _ ,, o w o - C -s qtr VW", -bit-(c& 11 ) Completion of the followingtable m be waived by the Inspector of Wires. lel No.of Recessed Luminaires No.of Cell:Sasp.(Paddle)Fans No.o Total Transformers KVA 4=,E No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grnd. grrnd. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones c. No.of Switches No.of Gas Burners -No.of Detection and iInitiating Devices Tota No.of Ranges No.of Air Cond. onsi No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals:1 �_ "`" " .....'' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work:�I 100 (When required by municipal policy.) Work to Stan: '7la a Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE1 GE: Unless waived by the owner,no permit for theperformance of the licensee provides proof of liability insurance includingon"coverage or itels substantial ubs al work may issueent. The undersigned certifies that such coverage is in force,and has,exhibited proof of same to the permit issuing office. CHECK The CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the ,sins and penalties of perjury,that the Inform, on o th' a FIRM NAME: ► ration ' e and complete. ( _ s_. ---��— `--' '2 Licensee: �..� � � LIC.NO.: • (A.A.- Signature A�,� LIC.NO.:__�F1 Licensee: applicable,enter xempt"in the lice e number line.) Address: " Bus.Tel.No..__________. *Per M.G.L.c 1 s 57-61,security work requires Department of Public Safety"S"License: Alt 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/Agent owner ■ owner's a:ent. Signature Telephone No. PERMIT FEE:$ •