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Home My WebLink AboutUntitled n La Ck Commonwealth of Official Use Only L Massachusetts Permit No. BLDE-22-006196 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:4/27/2022 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) 4218 HEATHERWOOD Owner or Tenant Richard Kenyon Telephone No. Owner's Address 4218 HEATHERWOOD,YARMOUTH PORT, MA 02675 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: R&R receptacles, switches, lights, new stove 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 Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers • 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 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 eorxmo,Fwsaah of 741a sacituuail3 Official Use Oni At * c7 q‘0 . nwics� Permit No. ;`�ZZ ' �l Occupancy and Fee Checked �' BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] leave blank I APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR12.00 (PLEASE PRINT IN INK OR TYPE ALL NNFOIi TION) _ Date: 1-//a64aa City or Town of: YArry oviin To the Inspector of Wires: 3 By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) y a 1 `? ge.c.LT,cam,„i c)o p V Owner or Tenant RCl,atc� ,'.,-, Yon Telephone No. ov Owner's Address ESorri.c dIs this permit fa conjunction with a Yes 0 Na ! (Check Appropriate Box) Purpose Building Lpa rT!Va✓iTUtility Authorization No.Existing Service Amps / Volta Overhead 0 Und grd C:} No.of Meters New Service ______ Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number at Feeders anal Acapathy Location tutti�Nature+f (d Electrical Work: R-i-g AL/L ce.0 acLs , .c Tells, ce.tc. .,, ()n��- c t1.c r Li .hT5 L'1 k r vJ/fSl/J c 1A1aLL c3Vtn a i Cock rzA 14 No.of Recessed Lures J Cam n � aw table may be waived by the'rotor of Wines, No.ofCeil-Snsp.(Paddle)Fans Na.of 'rotor Traesferms: at No.of Lume Outbsts No.of Hot Tuba Generators KVA No.of L Swimming Pawl Above Q Ia- o;No.of Emergency Ligating ttrnci. grad. lam*traits No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of� . No,of Gas Burners 'No.ofhiating De and tection 1 U No.of Rows No.of Air Cond. Totanf I No.ofAlerting ous 'Devices Na of Heat Pump Number ,Toes KW o�of -Contained stain — llevf ea No.of Dial Spate/Area Hen KW duo _ � ^' Q�� 0 other lvo,o>EI Donn t A pi*nae, Security , :, No.of Tear ' fe.of No.ouskf or dvxlent Hester* — Sims Boften' No.of Devices or E,. . No.Hydromassage Bathtubs No.of Motors Total HP T ' ' ,, No.of EoOtly Attach additional detail ifdestr d or or required by the Inspector of Wires. Estimated Value of Electrical Work (When required by municipal policy.) Work to Sort: Inspections to be requttsted 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',cavities proof of liability insurance including"completed operation"coverage or substantial equivalent The undersigned eenifies the such coviatge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND"0 OTHER 0 (Specify:) I cercijk,ruder the pains and penaltke ofperiwy,that the brformathon on this apprication.is true and complete. RIM NAME: D aZ E.LecTr:c. LL C LIC NO4 a l a7s 9 I Licensee: ; I)a();c.L i= m i Cc SOLTe. Sire , o,n.j)d'oV, u LIC.NO.::,SI 6�i,a,E (fek enter exempt"in the license nw nber lam) Bus.Tel.No.: 7 81 Rig q 170 Address: 6F, ELK Ran INc M; 66Le 6or-c PI 0a346 Alt Tel.No.: So 3 697 R1 8.5" *Pea'M.G.L.c. 147,s.57-61;security work requires Department of Public Safety"S"L i-elnre: Lic.No. ,..S C c -O O 1 3 73 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally requited by law. By my signature below,I hereby waive this requirement. I am the(check.one)0 owner :owner's agent. Sire Telephone No. . I PERMIT PEE:$ 0 — 1