HomeMy WebLinkAboutBLDE-22-004460 Commonwealth of Official Use only
fi ` Massachusetts Permit No. BLDE-22-004460
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:2/10/2022
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) 4 GULLS COVE RD
Owner or Tenant LOWENTHAL DANIEL A Telephone No.
Owner's Address LOWENTHAL NAOMI M,ONE SOUNDVIEW DR, LARCHMONT, NY 10538
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: Update smoke&CO detectors
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 11
Initiating Devices
No.of Ranges No.of Air Cond. Ton l 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 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: Gene A Cormier
Licensee: Gene A Cormier Signature LIC.NO.: 1592
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:9 MARGATE LN, SOUTH DENNIS MA 026602667 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:$45.00
Commonwealth.o/Maseacluaette Official Use Only
_,in=_ 2i= l cc�� cc77 Permit N .epartment of_tipe Spaces
Occu
-1(_ Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
Ems-, (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: February 8, 2022
'5 City or Town of: YARMOUTH To the Inspector of Wires:
WBy this application the undersigned gives notice of his or her intention to perform the electrical work described below.
a. Location(Street&Number)4 GULL'S COVE ROAD
Owner or Tenant NAOMI& DANIEL LOWENTHAL Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes El No ❑ (Check Appropriate Box)
Purpose of Building RESIDENTIAL Utility Authorization No.
Existing Service Amps / Volts Overhead n Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: TAKE OVER& UPDATE SMOKE& CO'S
Please FAX Permit&Permit#back-508-398-5666 or EMAIL - sales@capecodalarm.com Thank You
Completion of the followingtable may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans To
by the ofInspKVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- 1=1 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 11
Initiating Devices
vi No.of Ranges No.of Air Cond. Total No.of AlertingDevices
Tons
U No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
p Totals: Detection/Alerting Devices
-4 No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of WaterKW No.of No.of Data Wiring:
Heaters 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:$1985.00 (When required by municipal policy.)
Work to Start: 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 coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE El BOND ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Cape Cod Alarm Co., Inc. LIC.NO.: 1592C
C Licensee: GENE CORMIER Signature Otazyzete.„4,0„.„,,
,LIC.NO.•
(If applicable,enter "exem t"in the license number line.) Bus.Tel.No.:508 398-6316
Address: 204 OLD TOWNHOUSE ROAD WEST YARMOUTH, MA 02673 Alt.Tel.No.:800 468-8300
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. SS CO 000248
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 ❑owner's agent.
Owner/Agent I
Signature Telephone No. I PERMIT FEE: $ 45.00