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Home My WebLink AboutBLDE-22-006559 Commonwealth of Official Use Only -if-- A . Massachusetts Permit No. BLDE-22-006559 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:5/16/2022 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) 122 LEWIS RD Owner or Tenant MAIOCCA MARK Telephone No. Owner's Address MAIOCCA PAULA, 284 CHERRY ST, NEWTON, MA 02465 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: Bring basement up to code. 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- ElNo.of Emergency Lighting grad. grnd. Battery Units No.of Receptacle Outlets 2 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiative 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/Alertine 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 Ballasts Data Wiring: Heaters Signs 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 ❑ 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: Richard L Serpone Licensee: Richard L Serpone Signature LIC.NO.: 6910 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 183 PINE ST,YARMOUTH PORT MA 026752374 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: $50.00 1,64 /Veto .1i_ ^CE1YED ' 11<:'c„,...,asy MAY 12 r:_.' Commonwealth "w..a. i i/aeeachuaatld Official Use Only r >ii i c� �7 Permit No, =.�Z 4p BUILDING DE i r 2eparEmsni°Piro Serviced 'r t • BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank) ' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,c/a 2 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) jo7Z 2.P kJ t 5 iq Owner or Tenant 6p)y'e a,n c f Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building ❑ (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Ele/c/rical Work: ,gear t,, wl P? 6;A 1�fGI)c-R" 02 cc.!iet c b45C�N� avh�, jtoie Ccci / �kstvl/ An 1� Po 1 4i� �� Completion of the following table may be waived by the Ins ector of Wires. U. No.of Recessed Luminaires No.of Ceil:Sus .(Paddle) No.or p Fans Total �t No.of Luminaire Outlets Transformers KVA '‘ No.of Hot Tubs Generators KVA t" No.of Luminaires Swimming Pool Above In- ..,. No.of Emergency Lighting rnd. rid. ❑ BatteryUnits Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and 't' No.of Ranges Total Initiating Devices No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number.._Tons_ _ KW 'No.of Self-Contained , Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Lceal❑ Municipal No.of D era Connection ❑ 'they =Y Heating Appliances I{�,4, ecu ty ystems: Ni.oWater KW o 0 0 o No.of Devices or E uivalent Heaters Si ns Ballasts Data Wiring: No.Hydromassa a Bathtubs Na of Devices or E uivalent g No.of Motors Total HP a ecommun ca one g• OTHER: No.of Devices or E uivalent Attach additional detail if desired,or as required by the Inspector of Mires. Estimated Value of Electrical Work: Work to Start: (Whenrequired 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 covsrage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSU BOND 0 OTHER 0 (Specify:) I certify,under the pal nd Wallies o erju that the information on this application is true and complete. FIRM NAME: CkQ i- LIC.NO.: ly?/epLicensee: / t ' ,t (lfapplicable,eater"exemt"i the license number!' a Signature LIC.NO.: _ Address: 3� ew Bus.Tel.No.:_�`ls=3Lo �_' 9"3 f' *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.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. 1 am the(check one Owner/Agent owner • owner's a:ent. Signature Telephone No.P PERMIT FEE:$ 60 cfis61