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Home My WebLink AboutBLDE-22-004308 a ��!, Commonwealth of Official Use Only Permit No. BLDE-22-004308 fE (t Massachusetts 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•2/3/2022 _ 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) 65 CIRCUIT RD Owner or Tenant DIPIAZZA DAVID Telephone No. Owner's Address DIPAZZA DEBRA, 11 BERGEN AVE, HILLSDALE, NJ 07642 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: Remodel bedrooms, livingroom,dining room, &kitchen. 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. Igor-n Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 0 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 ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* NQ.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 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: ADAIR MARTINS ELECTRICAN Licensee: Adair Martins Signature LIC.NO.: 55688 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:215 Palomino Drive, Barnstable Ma 02630 Alt.Tel.No.: 5088156173 *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 ^1 A- 2.tk 1v7/ 6 o t a,''3-1" L/ ) NIA 4((z ((I) z�-c,A- LAO 04H Yq/ iljsilt (el 41)2.Xleg- 774- kh,i 72 /w ICE (42 &tZ) ,- geady FIXL g-{1U1 k -_ Commonwealth of//lassac�fls Official Use Only ='moi= `� c� C Permit No.p__,-2.-z.-14- 0 __I_�_ cparfinerf o f..tiro Services _ BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked •�,`• Rev. 1/0 T) (leave blank) ADEN- Ir`/[=T: I.1_ = !---f--,:: I=i •1.7 v rEc rvtun ELEG i{KCAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (PLEASE PRINT IN INK OR TYPE ALL INFORMATION02../a5 f °Date: 2 (MEC),527 CMR 1 z.00 City or Town of: YARMOUTH2 To the Inspector o of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) 6 5 it ) axma_i., ., • ,261-3 Owner or Tenant DAV I 1)0 lit' j A Z04' Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes --/' No . ❑ (Check Appropriate Box) Purpose of Building ReScckivka,l Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead E Undgrd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Dose 2 �v,.� arm /)1NI� o, On 01 t IG I.�,n -w'�ecp f��l bP�Dc els Completion of the followine table may be waived by the Inspector of fres. - No.of Recessed Luminaires lNo.of CeiL-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming t_pool Abovernd In- ❑ 'No,of Emergency Lighting ornd. Batter'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 Total No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW 'No.of Self-Contained Totals:I Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal Connection ❑ 7 No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of Heaters KW 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:OI Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COY RAGE: 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 ❑ 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 NAM • i / ' i `/'. ,a' J ' ,'A. LIC.NO.:3.5 Licensee: AL,. • th( 5 2 Signature ��'� 0 LIC.NO.: (If applicable,enter "exempt"in the lice - number line.) Address 1� f! Bus.Tel.No.:t"iDi3��31� 43 u e .� / . PA - Vb ( 02.6 Alt.Tel.No.: j "Per M.G.L. c. 147, s. -61,se 'ty work re. fres 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 n�— S 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. I PERMIT FEE: $