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Home My WebLink AboutBLDE-23-001476 Commonwealth of official Use Only €.0Massachusetts Permit No. BLDE-23-001476 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:9/20/2022 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) 22 EDGEWATER DR Owner or Tenant PEZZELLA PATRICIA M Telephone No. Owner's Address 16 ADAMS FARM RD, SHREWSBURY, MA 01545 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement HVAC. 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 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 1 Totaln No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection Other: No.of Dryers Heating Appliances KW Security Systems:* ry No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: y g 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: Joseph W Silva Licensee: Joseph W Silva Signature LIC.NO.: 9147 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 BOURNE HAY RD, SANDWICH MA 025632761 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 ❑ owner's agent. Owner/Agent I Signature Telephone No. PERMIT FEE: $50.00 (.ome:van/ea&of!l/addadwAsth Official Use Only „ ;= Permit No. 23—( 17i...,_ -,4,___; '--r-a: -.-1 1/4 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07j (loalve 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 TYPE ALL INFORMATION) Date: y--e ZZ City or Town og /1 �! To the Inspector of Wires: By this application the undersignea gives notice of his or her intention to perform the electrical work described below. QC Location(Street&Number) 0-Z.- )�'6t ct9-77 - Dg_. 8 Owner or Tenant �'rc Y T Telephone No f Fg/-V Fos J Owner's Address i-i+'ii- Yes NoAppropriate lr Is this permit in conjunction with a building permit? ❑ �_ (CheckBox) u Purpose of Building/CCt Q lam" Utility Authorization No. il Existing Service Amps I Volts Overhead❑ Undgrd❑ No.of Meters siNew Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity 4 Location and Nature of Proposed Electrical Work: ,�-CoAr.,, i'x - Aft,,,, ' -S �f J /w e. �it/�r�i5- S: Completion ofthe followinntable maybe waived by the Inspector of Wires. No.of Total `i No.of Recessed Luminaires No.of Ceil-Burp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool mod- ❑ an& ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Air Cond. Total No.ofAlert Alerting Devices No.of Ranges Tons . Heat PumpNumber]Tons (,KW No.of Self-Contained No.of Waste Disposers Totals:I j opal Alerting Devices No.of Dishwashers Space/Area Heating KW Looms 0 Municipal ❑ Otlmr No.of Dryers Heating Appliances KW S Na ofSD or Equivalent No.of Water No.of No.of Data Wiring:, . Heaters KW Signs Ballasts No.of Devices or I -{t _ Telecommualcations ' . No.IIydromassage BsthtaM - No:of Motors Totally No.off or -i , ut OTHER: Attach additional detail(fdesire4 or as required by the Inspector of Wires. Estimated Value of Electrical Work (When required by municipal policy.) �� Inspections to Start:9�t 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 "completed operation"coverage or its substantial equivalent. The the licensee provides proof of liability insurance including p of same to the permit issuing ofii .._ _- undersigned certifies that such coverage is in force,and has exhibited proof ��/� -�1 Grp CHECK ONE: INSURANCE [BOND 0 MI ER 0 (Specify:) V 1 certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: .s,k4A- £Leo(21G.. LIC.NO.A ?/`f7 it-d� Si LIC.NO.: ZIG�7 Licensee: S bsE ph '£ Bus.TeL No.•, `f2'g�'�F` Address:< Bo thelicense number line lU Al� 0Z.5-A 3 Alt,TeL No. 'ft.--3G�`t` 5 f I Address:< � *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 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.I Owner/Agent Telephone No. ,PERMIT PEE:$ Signature