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HomeMy WebLinkAboutBLDE-21-001648 o* Commonwealth of Official Use Only CSri am,. Massachusetts Permit No. BLDE-21-001648 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:10/1/2020 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 110 DIANE AVE Owner or Tenant PARADISO RALPH R Telephone No. Owner's Address PARADISO JO-AN M, 169 CLAFLIN ST, BELMONT, MA 02178-3215 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Affroptiate Box) Purpose of Building Utility Authorization No Existing Service Amps Volts Overhead 0 Undgrd 0 New Service Amps Volts Overhead 0 Undgrd 0 o of ,( Z Number of Feeders and Ampacity r 4 Location and Nature of Proposed Electrical Work: Replace panel&remove off peak meter. ficti Completion ofthe followingtable may71e w8467, ct Wires. P , No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans NTransformers No. i 'ta No.of Luminaire Outlets No.of Hot Tubs Generators AAt 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 Initiating 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/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 Data Wiring: Heaters Siens 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: 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: George S Pizzuto Licensee: George S Pizzuto Signature LIC.NO.: 7768 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:43 FRANKLIN ST,WATERTOWN MA 024724020 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 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 P ' A Coaunonwoa yy�el ir/aeese/t ueeas Official Use Only • n '� c�o�� c� Stroked Permit No. cif �S e o 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 (PLEASE PRINT IN INK OR TYKE ALL INFORMATION) Date: /6 2 /aQ- City or Town of: \/�l1a C/ h To the Inspector of Wires: c:, By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street do Number) l/ 0 Q/6t//tiY �'I/r. S vi 6 r f}ler*V*h Owner or Tenant K ft Q/f 1'f le-14 0/5 B Telephone No.G/7-� q—,.S' 7/° zOwner's Address f( e C L H FG/i✓Sfi ere?'/ f e -,T 6,4-1 ,A7 4 OPc/7* v Is this permit in conjunction with a building permit? Yes 0 No © (Check Appropriate Box) Purpose of Building Q W-PtL(y6 Utility Authorization Na ?L/C'7 e/7 N. Existing Service °G Amps (96 /ac-/G Volts Overhead Undgrd 0 No.of Meters J N i s New Service a °G Amps / -c I .21-/yVolts Overhead Undgrd ElNo.of Meters / Number of Feeders and Ampadty S C..6 London and Nature of Proposed Electrical Work: REP/ (vt r(Q(°or eiE-1r6Je Wee-- , tePAfoVe ofP14 eye/ t e , VA K g Completion of the.foll toble a p Total t be waived by the Inspector of Wires. „ No.of Recessed Luminaires No.of CeIL-Susp.(Paddle)Fans o,Transformers VA / s ' No.of Luminaire Outlets ` No.of Hot Tabs Generators r.--,N ,. No.of Luminaires Swimming P Above ❑ In- ❑ No.cry U tt� grid. grad. Battery No.of Receptacle Outlets Na of Oil Burners FIRE No� 3 No.of Switches No.of Gas Burners Ra of �' 1,` No.of Ranges Na of Air Cond. Ton' No.of I/p2� Na of Waste Heat Pump Number Tons_. KW__ No.of v ,,:-.� Totab: Detection/Ale �'�,, Na of Dishwashers Space/Area Heating KW Local❑ bun CyyoaneMion No.of Dryers Heating Appliances KW Security offD�cvte ss or Equivalent No.of Water KW No.of No.of Data Wing. HeatersSiyns Ballasts Na of Devices or nivelent No.Hydromasge Bathtub Na of Motors Total HP Tel m ss t OTHER: 8 9 0 _Cu Vr DEUfer Pi tiF �Attach additional detail if-desired,if-desired,or as required by the Inspector of Wires. Estimated ValueG�of Electrical Work: ' (When required by municipal policy.) Work to Start 9/- /ac off' 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 1[] BOND 0 OTHER 0 (Specitjr:) I cettJy,under a and penalties of perjury,that the information on this application is true and completes FIRM NAME: 6 e JD/Z Z U/c ECCC-i P I tc 0,7, LIC.NO.: G77(P e- Licensee: G'e-Q& S• -i"l22 c to Signature.,a4 Cec LIC.NO.: C/S` fO& (If applicable.enter"exempt"in the license nronber line.) Bus.TeL No.4/7-y's4 -95Y 6 Address: if 3 Pe/Wt.`(N SI, we-i-eaficwti/� g. (yay 72- Alt.TeL No.:e/7-74y -3 .7. ePae- *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. ( PERMIT FEE:a , —