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HomeMy WebLinkAboutBLDE-22-000180 Commonwealth of Official Use Only . Massachusetts , Permit No. BLDE-22-000180 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:7/12/2021 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) 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: Repairs as required per inspection. 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 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons Tot No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* ry No.of Devices or Eauivalent 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 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: Gerard J Mazzola Licensee: Gerard J Mazzola Signature LIC.NO.: 24610 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 POUND STREET,UNIT 404,MEDFIELD MA 020522622 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. 'PERMIT FEE: $100.00 Comneronweaa of I aeeacissisilfa Official Use Only ,• • v c� Permit No. ((�2•' ©' 66 a L. cc-7�� ..L.Jepartntsnt oi.tiro&evicts Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) ,...1 3 _ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK N All work to be performed in accordance with the Massachusetts Electrical Code(M ),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INF TION) Date: 7 Ii 2-A ti City or Town of: A2 vt4c to To the Inspector of Wires: By this application the undersigned,gtvess7notice of his or her intention to perform the electrical work described below. Location(Street&Number) / , �1,� Owner or Tenantg.t;,f2,;yyplJ .J , „,,� Telephone No 0-11 �e13 c9-0 Ole ! Owner's Address 7 1 AkE•z 5-f— 1 PS I ( L'V)..� . 0.4V IB Is this permit in conjunction with a building it? t.. Yes No 0 (Check Appropriate Box) b Purpose of Building 64/2,1,1 S tUt,Nt.Gev l eau c. i2CA-Utility Authorization.No. Existing Service 1)C U Amps t(o / :).2t Volts Overhead rJ Undgrd❑ No.of Meters ``' New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity j 6 A-norh t -3 /Ge-i.S Location and Nature of Proposed Electrical Wong ( ' .01 a't C} u i Ove-t Pc 0 C.C r., ! ( u-r@ ,e- 2 44 C I, /w4— v.) 1 i Completion of thefollowingtable my be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-S (Paddle)Fans No.of Total Transformers KVA .) No.or Luminaire Outlets No.of Hot Tubs Generators KVA KZ\ Above In- No.of Emergency LightingNo.of Luminaires Pool grad. ❑ und. ❑ Battery Units 4' No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and °- Initiating Devices 1 UU No.of Ranges No.of Air Cond. Tons No.of Alerting Devices on rs Heat Pump Number Ts__M KW._ No.of Self-Contained O.of Waste Totals: .. Detection/AlertintDevices No.of Dishwashers Space/Area Heating KW Local 0 CoMuniclial nnection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No. .of Data Wiring: Heaters Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP 'TelecommunicationsNo.of Device evicer W N or Equivd nt OTHER: . Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of lectrical Work: , ri) (When required by municipal policy.) Work to Start: /Jr )- Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 certify,under the ins and pe ties of perjury,that the information on this application is true and complete. FIRM NAME: 6/i-A-R. -- V‘A,A'LZ 0(rl- LIC.NO.: Licensee: • Signature LIC.NO.: �+ (Ifapplieab �{A►ter exempt i►�fiee ti use number line. ` Bus.TeL No.'�1(- 717"v'- i Address:1 'I0 vANC�C14 tN.V 4,-4401 L,(.tTt.tA- ri v tt ` 6(tto Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE W IVER: I am aware that the Licensee does not have the liability insurance coverage normally required by . By si below,_I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/A Telephone No. 7fl b f PERMIT FEE:$ /0C),�I Signature .4-4 1"; 10 C. 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