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Home My WebLink AboutBLDE-22-006631 (V)0 Commonwealth ofofficial use only Or Permit No. BLDE-22-006631 � 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 Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:5/17/2022 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) 864&878 ROUTE 28 Owner or Tenant DIGIOVANNI GERARD J Telephone No. Owner's Address DIGIOVANNI JOSEPH, 67 BAKER ST, BELMONT, MA 02178-4024 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: Miscellaneous repairs as noted over the last few years and not performed. 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 10 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatine 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 Siens 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 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: Daniel H Lax Licensee: Daniel H Lax Signature LIC.NO.: 14305 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:22 RALEIGH RD, BELMONT MA 024782838 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: $100.00 4 C - .• • 1 , Ew1G r( S 'c G� 1;RECEIVED MAY 17 `•4' Commonwealth o/ aeaachusat`fd . cc�� nn Serviced Official Use Only BUILDING D F% 'r �(Is/oa,j,n n F o/. ins Jsrvasd Permit No. �-- �J( By' _1 N t I._,0 _ OARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev. I/07] (leave 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: City or Town of: the--,-!? By this application the undersigned gives YAnotice RM his OUTHintention to peTo o the elect 'cal o work itde-gibed below Location(Street&Number) ? 61 z/ /7/9j°4, . " �„r �F� Owner or Tenant ems- 6e '�a`�'`� Telephone No. e/7 a psas Owner's Address 6 T , e s; e 74;4,.L Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building Cc/ (Check Appropriate Box) 7`f . es Utility Authorization No. Existing Service Amps Volts Overhead New Service ❑ Undgrd El No.of Meters _ Amps / Volts Overhead❑ Undgrd Number of Feeders and Ampacity g El No.of Meters i Location and Nature of Proposed Electrical Work: _ a, et s+v //l/-s e car /S � r/ 4/' /� QCP 1 e/7s vs, Completion o the ollowin_ table m be waived b the Ins.ector o Wires. ' No.of Recessed Luminaires No.of Cell:Snsp.(Paddle)Fans T oa o ota �t No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA ,'t'• No.of Luminaires n- o•o Swimming Pool ,rnd'ove. nd No.of Receptacle ❑ B'an.e Units g n g Outlets �a No.of 011 Burners • � FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners `o.o etec on an i t' No.of Ranges Initiatin. Devices No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers 'eat 'ump `um er ons "' Totals: o.o e - onta ne• No.of Dishwashers Detection/Alertin, Devices Space/Area Heating KW Local 0 .un a pa o No.of Dryers Heating Appliances KW ecu ty Cstems: other No.o "a er .o o No.of Devices or E•uivalent Heaters KW o.o Data Wiring: Si ns Ballasts No.of Devices or E•uivaient No.Hydromassage Bathtubs No.of Motors Total HP a ecommun ca•ons " r i gg: OTHER: No.of Devices or E•uivaient ,' Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value ofElectrical Work: Work to Start: S/7 2.Z (When required by municipal policy.) 1? P° � Y) INSURANCE OVERAGE: Unless pwaived by the owner,nopermit elested in for the performance of e with MEC Rule ele trical work issueayti the licensee provides proof of liability insurance including may nt. unless undersigned certifies that such coverage is in force,and has'exhibited proof of same to the permit issuing office. CHECK The CHECK ONE: INSURANCE E' BOND I certify,under the pains and penalties o El OTHER 0 (Specify:) fper ury,that the information onthis application is true and complete. FIRM NAME: f�'��f�Z Licensee: p g�i�`� G �k LIC.NO.: 24517 C /qnu Signature ------_____(If applicable,enter"exen t"i the lice a num r li e.) � � LIC.NO.: /`,34 5 4 Address: Z� SBi �� *Per M.G.L.c. 147,s.57-61,s uriiy work requires Department of Public Safety zie 7 Bus.Tel.No.:.2/ _.. D� Alt.Tel.No.:OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normallyty"S"License: Lic.No. .----- OWNER'Srequi Owner/Agent law. By my signature below,i hereby waive this re uirement. I am the(check one edbyla q g Signature � owner �owner's a:ent. Telephone No. PERMIT FEE: