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Home My WebLink AboutBLDE-22-003644 of Commonwealth of Official Use Only i- ,%It Massachusetts Permit No. BLDE-22-003644 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:12/29/2021 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) 107 LEWIS RD Owner or Tenant ARANIZ ENRIQUE A Telephone No. Owner's Address ARANIZ MARGARET, 15 ALEXSANDRIA DR, MEDWAY, MA 02053 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace meter socket 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 0 In- ElNo.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 Ton Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine Devices Municipal 0 Other: No.of Dishwashers Space/Area Heating KW Local ❑ Connection 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 Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. required bymunicipal policy.) Estimated Value of Electrical Work: (Whenq p p 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ADAM G LEPIRE LIC.NO.: 21742 Licensee: Adam G Lepire Signature (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:8 PICASSO PL, OSTERVILLE MA 026551245 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 0 owner's agent. Owner/Agent Signature Telephone No. (PERMIT FEE: $50.00I �Lk 5 (1,0:20 .. W ( q Caq Commonwsa[t/t el Maeeachuest{fe Official Use Only r 1111 / .CJs/vartmsnf oi c7 Permit No, �1 —g Vet ._furs�srvicse ✓" ,17 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK cY All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: i,2.-* .4 1/'- I City or Town of: YARMOUTH To the Inspector of Wire � ' '7 By this application the undersigned gives notice of his or her intention to perform the electrical work described below. v Location(Street&Number) Jo tz"4 r.< . /� jb Owner or Tenant ..c fa./r � �' JS Telephone No. `176 •� �,• i j �(,� i Owner's Address 1 ! I Is this permit in conjuac n with a building permit? Yes ❑ No (Check Appropriate Box) ,v' Purpose of Building t , ice Utlli Authorization No. Existing Service /(.)(f Amps lAv / 42 /lYolts Overhead" Undgrd❑ No.of Meters q•••) New Service 1/of Amps / 0/ � olts Overhead KY Undgrd 0 No.of Meters Number of Feeders and Ampacity `A ( i ` �� Location and Nature of Proposed Electrical Work: Jt^VC�-.,`�> -fia 6v/ v7.id It p Completion of the followinktable m be waived by the In ector of Wires. tikU n4 f No.of Recessed Luminaires No.of Cell:Snsp.(Paddle)Fans No.off Total Transformers KVA 't No.of Luminaire Outlets No.of Hot Tubs Generators KVA Cs t No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting brad. gird. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas Burners No.of Detection and 1. No.of Ranges Total Initiating Devices g No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons KW tNo.of Self-Contained Totals: j Detection/Alertingpevices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* .of No.of Devices or Equivalent No No.of Water No.of e q Heaters KW Data Wiring: 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 E ctrica Work: (When required by municipal policy.) Work to Start: 2. Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO E: nless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability' surance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) I certify,under the s and penalties o perjury,t�hat_thf info mation on this application is true and complete. ® , RM NAME: '4-'77 V Z=- I l / LIC.NO.: A 2- w ! icensee: L- I'/r. Signature � LL ' �-- 2 I I applicable e ter in the license number line.) _ LIC.NO.: f Pp >1 c s 1 . ddress: 1 fL C — �77c (2 ,/ems l Bus.TeL No.. 7 i Per M.G.L.c. 147,s.57-61,security work requires fPublic Safety S" icense: AILLic.No. 7`� r �� r I WNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally Iequired bylaw. Bymysignature el Cr3 z i below,I hereby waive this requirement. I am the(check one)[]owner 0 owner's agent. Qz t ner/Agent lgnature Telephone No. I PERMIT FEE:$ so ---1