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Home My WebLink AboutBLDE-22-005860 Official Use Only �- Commonwealth of Permit No. BLDE-22-oossso _L 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 Massachusetts4l Code (M PLEASE PRINT IN INK OR TYPE ALL INFORMATION) To the Inspector of Wires: City or Town of: YARMOUTH By this application the undersigned gives notice of is or er intention to perform the electrica work described below. Location(Street&Number) 28 CAPT BACON RD Telephone No. Owner or Tenant DIMAIO MARY J Owner's Address C/O WILLIAM DIMAIO, 12 ORCHARD ST, BYFIELD YQM 1922 No ❑ (Check Appropriate Box) Is this permit in conjunction with a building permit? Utility Authorization No. Purpose of Building Undgrd 0 No.of Meters Volts Overhead g No.of Meters Existing Service Amps Volts Overhead ❑ Undgrd ❑ New Service Amps Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wirin for ara e&sub panel. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.Susp.(Paddle)Fans ran form•r VA of Hot Tubs Generators KVA No. No.of Luminaire OutletsIn- No.of Emergency Lighting I Swimming Pool Above ❑ ❑ Batt•r nits No.of Luminaires o- rnd. FIRE ALARMS No.of Zones No.of Oil Burners No.of Receptacle Outlets .No.of Detection and No.of Gas Burners I of D•vi • No.of Switches No.of Ranges No.of Air Cond. Total No.of Alerting Devices To Number Ton KW No.of Self-Contained Heat Pump I •to do Al•rtin' D'vice No.of Waste Disposers T�tals: Local 0 Municipal 0 Other: Space/Area Heating KW onnc No.of Dishwashers Systems'* Heating Appliances KW SecurityNo. y vi te in s i uivale t No.of Dryers Data Wiring: No.of No.of Ballasts He of Water KW No. of Devi •s I ! i a •it �' 's Telecommunications Wiring: Heat•rs Total HP No.Hydromassage Bathtubs No.of Motors .oo Icy' • a E i Wiring: it OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. (When required by municipal policy.) Estimated Value of Electrical Work: Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. f electrical work may issue unless the licensee INSURANCE COVERAGE:Unless waived by the owner,no permitor the performance ivalent The undersigned certifies that such coverage proof of liability insurance including"completed operation coverageor its substantial equ is in force,and has exhibited proof of same to the permit issuing office. S eci 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: MICHAEL F SIMONIS LIC.NO.: 1s8s2 Licensee: Michael F Simonis Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Addfiresress:PO BOX 1488, EAST DENNIS MA 026411488 *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❑theoW eir ity in owner'surance en coverage normally required by law.But my t. signature below,I hereby waive this requirement.I am the(check one) Owner/Agent PERMIT FEE: $75.00 Telephone No. Signature aok Li. (c ()z eonuxonivsaa of maeeac'W al Official Use On ,. ire Permit No.�22- 0 t) Apartment Servicof Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) ti APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.00 i (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /7 j.z J City or Town of: /. f/.."!o a T7 To the Inspector of Wires: qBy this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) c2 S e -4-/ 73 4-c n 72-7::). Owner or Tenant 73/ II ?'S/'o c,,,-4/ Telephone No. Owner's Address 5 .'-*'"t'e- Is this permit in conjunction with a building permft? Yes No ❑ (Check Appropriate Box) Purpose of Building , -7t ffe' a. -f-f2.gf-6 E Utility Authorization No. Existing Service Amps / Volts Overhead ElUndgrd 0 No.of Meters U New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters 0 Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: /Z v vq 01, -t- 0:.-_-,..-,•s I^ '*J,1., 'V c-�✓ t e. ,4—rr',4.1/e-1> G•4-/L 4 4'e v.J/ri'f S v"Pel+-t'e/ Completion of the following table may be waived by the Inspector of Wires. No.of tb No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Transformers KVA No.of Hot Tubs No.of Laminaire Outlets Generators KVA Above In- No.of Emergency Lighting - No.of Luminaires Swimming Pool grad. ❑ grnd. ❑ Battery Units '.1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 4. ` No.of Gas Barren No.of Detection and No.of Switches Initiating Devices 4. Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices Heat Pump m Numbed Toes fKW _,. No.of Self-Contained No.of Waste Disposers Totals: _. T _Detection/Alerti Deviees - No.of Dishwashers Space/Area Heating KW Local❑ CierSystems:*nn ❑ � Security No.of Dryers Heating Appliances KW f Devi or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Telecommunications W No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equiv t OTHER: I Attach additional detail if'desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) completion. to Start: l7 /. ....... Inspections to be requested in accordance with MEC Rule 10,and upon INSURANCE OVERAGE: Unless waived by the owner,no permit for the performance electrical work equivalent. They issue its the licensee provides proof of liability insurance including"completed operation"coverage or undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE a'BOND 0 OTHER 0 (Specify:) %/2-"s e-`/'e Ie. r'. I certify,under the pains and penalties of perjury,that the information on this application is true and complete FIRM NAME: 5-"i"/0 n r S , /-e 7`/-.i c- T ti L LIC.NO.: re-/b 8 uo Licensee:„X''4.4-•0/ Sys •--r/S Signature r�sse--A-A LIC.NO.: y 3e -3 g (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.;C—A8 88!'-86 117 Address: /'0. ,50 K /V Fr ,E. v en•'tr,s y"l 4• a a G Y/ Alt.TeL No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not 4ave 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. I PERMIT FEE: 7S%°O I