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Home My WebLink AboutBLDE-22-007403 Vt Commonwealth of Official Use Only • ` c Massachusetts Permit No. BLDE-22-007403 ' 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:6/24/2022 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) 19 CAPT BESSE RD Owner or Tenant LOVELY DOROTHY A TR Telephone No. Owner's Address LOVELY REALTY TRUST, 19 CAPT BESSE RD,SOUTH YARMOUTH, MA 02664 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: Add GFCI receptacle to existing circuit. 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 1 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 Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: John M Pimental Licensee: John M Pimental Signature LIC.NO.: 27968 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 1158 E FALMOUTH HWY, EAST FALMOUTH MA 025365455 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 SiOill'. ti Couttnotuvea f .. 7 i//aaaacrtt�etue Official Use Onl --7 0 3 f li �`pat�aun!o�.tine—cervical Permit No. BOARD Occupancy and Fee Checked OF FIRE PREVENTION REGULATIONS 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 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice ofhis or her intention to perform the electrical work described below. Location(Street&Number) i' f Cove I- i3e ss•.� j• Owner or Tenant O/ 194,r ef,b.' ek Telephone No.So 320 Z Z So Owner's Address 3 ,Q_ Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Buildingj,� �(,d wy (Check Appropriate Box) 1 Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd Number of Feeders and Ampadty El Na.of Meters Location and Nature of FAO A. Proposed Electrical Work: pr rate_ t0 Cir',sit^f Git4 Lb Completion of thefollowingtable m9,,be waived by the Inspector of Wires. el No.of Recessed Luminaires No.otCdFans l.-Soap.(Paddle) Pa.,o otal n``- Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires swimming Pool Above 0 Ia- No.of Emergency Lighting - i No.of Receptacle Outletsd' ttrnd. ❑ Battery Units No.of Oil Burners FIRE ALARMS LNo.of Zones No.of Switches No.of Gas Burners +No.of Detection and 11,1 No.of Ranges No.Ok Air Cond. Total Inftfatia8 Devices Tons No.of Alerting Devices No.of Waste DisposersHeat Pump Number .ins _I.K%D 'No.of Self-Contained Totals:I' " "_ _.`"'. Detection/AlertinDevicea No.of Dishwashers Space/Area Heating KW Local 0 aunt ipaln ❑ other - No.of Dryers Heating Appliances , Security Systeme: No.of Water KW No.of No.of No.of Devices or Equivalent Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiirr�n� OTHER: No.of Devices or Egnlvdent Attach additional detail IIfdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal Work to Start:G-1 S zZ, 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 6" BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: Licensee: o 1"tGl�l/ Signature LlC.NO.: LIC.NO.: 27 fLS t` (Ifapplicable enter" t"in the license num line) Address: .G 16 Lh lam. A *aty d•Z fic. Bus.TeL No.: of b L TeL No *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. I am the(check one • owner ■ owner's::ent. Owner/Agent Signature Telephone No. PERMIT FEE:$