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Home My WebLink AboutBLDE-21-006050 .0, Commonwealth of Official Use Only Ii_litil IEMassachusetts Permit No. BLDE-21-006050 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:4/21/2021 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) 20 LOCH RANNOCH WAY L e-- '7y' p-83213 Owner or Tenant GONZALEZ MARIO A Telephone No. Owner's Address POLITO JANET MARIE,20 LOCH RANNOCH WAY,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: Install generator&transfer switch. 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 1 KVA 22 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 ❑ 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 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: 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: HENRY LARKOWSKI Licensee: Henry Larkowski Signature LIC.NO.: 26990 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:91 HOKUM ROCK RD,PO BOX 267,DENNIS MA 026380267 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 NyA_ ill* t4. Qom ( t.,0 eamenotzuwatth eir f/fad•3acLt.+.54 • Official Use Only // �f Permit No. � - LO l�S O ._ {_ depart Rt oi 5 , -` BOARD OF ARE PREVENTION REGULATIONS Occupancy and Fee Checked ev. l/07� --.-.-- (Ieave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ,527 I2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION} Date: Z a a City or Tour l of: YARMOUTH To the Insp for of es By this application the undersigned gives notice of his or her intention to perform the electrical w described below. . Location(Street&Number) O . tc.� C, f /`i' R s yV(')C' f.)J kV ' "1 Owner or Tenant i1 D ��U ��(.._ 7---_ Telephone No. Owner's Address S i� Is this permit in conjunction with a bonding Purpose of Building permit? Yes 0 No 2c1 (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps I Volts Overhead Q Un dgrd Number of Feeders and Ampacity ❑ No.of Meters Loca.tdpn and Nature of Proposed Electrical Work: ?2, EI-C/ a ()S 1 q4S, SL.c I �t LJO !? ) tom y(1 Gv)`1c� z., 11 Completion of thefollan ink table may be waived by the Inspector of I of Recessed Luminaires !Na.of Ce7.-SBsp.(Paddle)Fans No.of Total No.of LuminQire Transformers KVA Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Abodve ❑ In-d_ Q NBatt N -IIai cYLIgliting Rrn No.of Receptacle Outlets No.of On Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges `' Initiating Devices - d �' No.of Air Cond. Tons No.of Alerting Devices f No.of Waste Disposers Heat Pump Number IToas I KCW No.of Self-Contained Totals:1 Detection/Alerting Devices No.of Dishwashers SpacelArea Heating KW I,ical❑ Municipal Connection j No.of Dryers r ❑ mer O Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent HeatersnNa,of Data Whin Signs Ballasts No.of Devices or t1.1 No.Hydromassage BathtubsEquivalent J No.of Motors Total HP Telecommunications Wiring: (I') OTHER: No.of Devices or Equivalent Estimated Value o lectrical Wol /PCs Attach Additional detail if desired or as required bj,the Inspector of Wires. Work start (When required by municipal policy.) "� W rk to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. VE GE: 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: INSURANCE1 I certify, under the pains and enaft BOND ❑ OTHER 0 (Specify, . Il L /�5 CO. iZ2 FIRM NAM of p ,that the info n a istr is true and complete. l Licensee: �f LIC.NO.�_ (Ifa licabl 4 Signature , -UY__.i _ LIC.NO.:[ v\ pP "(n t in the license n um _�� . Address: e. c Pip o-r b 7�),,,s,—, Bus.Tel.No.: CI j *Per M.G.L.c. 147,s.57-61,security work requires D P �y"� Alt Tel.No.: OWNER'S INSURANCE WAIVER; lamapartment o bile Safety"S"License: Lic.No aware that the Licensee does not have the liability I i insurance coverage normally S required by law. By my signature below,I hereby waive this reauirement ra