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Home My WebLink AboutBLDE-23-000294 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-000294 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:7/19/2022 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) 70 GREENLAND CIR g-pet Owner or Tenant Mario Ranalli Telephone No. Owner's Address 70 GREENLAND CIR,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: Outlets switch&outside light 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 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 Gas Burners No.of Detection and No.of Switches Initiatine Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine Devices Space/Area HeatingLocal ❑ Municipal No.of Dishwashers P KW Connection 0 Other: HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent No.of Motors Total HP Telecommunications Wiring: No.Hydromassage Bathtubs 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.) y' 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address: *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 I PERMIT FEE: $75.00 I Signature Telephone No. K 0 c 64 te11 C CJ `2 1 Commonw.at o`/f/ Official Use Only �, ry-�.a. sense ueslfe _ -0'F .[Jspat+na,t ol�ln Jsrvicse Permit No. aj / f' 11 7 `—,-gym BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked _ [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in --�. ce with the Massachusetts Electrical Code(MEC),527 CMR 12.00 �_ (PLEASE PRINT IN INK OR TYP AL�ORMATION) City'or Town of: ,/ Date: � — / � -- 2 r� 2 �- 4 By this application the undersigned giv s ot�t his or her UTH intention to perform the elTo the ectrical work described Location(Street&Number) � / below. Owner or Tenant ��.�,�' A f _ �� Owner's Address 1 Telephone No. '=C�' � ` tee �b Is this permit in conjunction with a building permit? Yes ® No Purpose of Building El Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters ANew Service Amps / Volts Overhead Number of Feeders and Ampacity ❑ Undgrd 0 No.of Meters I Location and Nature of Proposed Electrical Work: UrJTL ----S w 1 E 6 t3 ( t 1, / %f u Com p letion o the ollowin: table in be waived b the Ins.ector o Wires. �' No.of Recessed Luminaires ! No.of Ceil:Sasp.(Paddle)Fans0. °•° ota �t No.of Luminaire Outlets Transformers KVA C.1No.of Hot Tubs Generators KVA' No.of Luminaires Swimming Pool 'owe ❑ n_ o.oe mergency g rig No.of Receptaclernd. °d• ❑ Batts Units Outlets No.of Oil Burners FIRE ALARMS No.of Zones '-- No.of Switches No.of Gas Burners `o.o t etec on an No.of Ranges Initiatin, Devices it i No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers 'eat 'ump `um er ons ' �' Totals: eo.t o e onta ne No.of Dishwashers Detectionalertin Devices Space/Area Heating KW Local `un a pa No.of Dryers Heating Appliances eca Connection ❑ Ome' `o.o "a er KW ty ystems: Heaters KW °•° o.o No.of Devices or E i uivalent Si ns Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Devices or E i uivalent No.of Motors Total HP c ecommun ca 1 ons " rag: OTHER: No.of Devices or E i uivalent Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: (When required by municipal policy.) 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 0 BOND ❑ OTHER 0 (Specify:) I cerdfr,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: LIC.NO.: Signature LIC.NO.: (If applicable.enter"exempt"in the license number line.) Address: Bus.Tel.No.: "Per M.G.L.a 147,s.57-61,security work requires Department of Public Safe S"License: Alt.Tel.No.: ____ -- Lic.No. OWNER'S I U NCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by my sigrkaturreel ,I hereby 've this r quirement. 1 am the(check one Owner/ en owner owner's a:ent. Signature G�/!/W ho o. PERMIT FEE:$