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Home My WebLink AboutBLDE-22-005886 Commonwealth of Official Use Only ttsi Massachusetts Permit No. BLDE-22-005886 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:4/14/2022 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) 109 SEAVIEW AVE UNIT 3 Owner or Tenant Patrick Hines Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd ❑ 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: Install pump. 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. Total No.of Alerting Devices Tons 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 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 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: Licensee: Scott Casto Signature LIC.NO.: 23195 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: Westport MA 02790 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: $75.00 I A- Cl/617 jv C-e- 6!2 0 tUt OAS) g)11L,V2) ' '' .l', V 170(W/ -.g- 60 6,--ecoctAstp7415' tiumzfz# weafit6-6 Oktfrre cqyz.,.Aile_Aiti) 14aPu -ra .t-(A-D E LIP RECEIVED PR13 2022 oni++orswsa of�j / ��_-__ �/ //(assactu�alfs ,_• •• Official Use Only ___�_`_ �fj: / c Permit No. i--Cd ING DEPARTMEN17)P ( 54"J'c,vress ''L I •- PREVENTION REGULATIONS Occupancy and Fee Checked _ ev. 1/07) eave blank ,: -. :;;, v =Ei RM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:)'527 cMx 1 z.ao City or Town of: y______ H ires: By this application the t,tridersigned gives notice of his or her intention to perform the electrical work To the e or ofdescribed below. Location (Street&Number) p A Owner or Tenantf P�„ A i -�► elephone No.Owner's Address _ ,,..- _ S, Is this permit in conjunction with a building permit? es r / � x0 El (Check Appropriate Sox) Purpose of Building `) 'GiL-► • 4.1- Utility Authorization No. Existing Service jal,S Amps i42 0 / 'YO Volts Overhead ❑ Undgrd El No.of Meters New Service Amps / Volts Overhead Number of Feeders and Ampacity ❑ Undgrd No. of Meters Location and Nature of Proposed Electrical Work: 1.4 'i Completion o the ollowing table m, be waived• the Ins.ector a Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans o.of Transformers Total No. of Luminaire Outlets No.of Hot Tubs KVA Generators KVA No.of Luminaires Swimming Pool Above In- 'o.o mergency • ,an =md.. ❑ grad. ❑ Batte • Units _ - g No. of Receptacle Outlets No.of Ott Burners Minn No.of Switches No,of Zones No.of Gas Burners "o.of Detection and No.of Ranges Initiating Devices No. of Air Cond. o • Tons No,of Alerting Devices Heat Pump umber Tons W o.of elf-Contain. No,of Waste Disposers Totals: Detection/Alertin_• Devices No.of Dishwashers Space/Area HeatingKW' Local❑ Municipal No.of Dryers Connection_ L. Other r3 Heating Appliances , Security Systems:* ' No.of ater No.o No.of Devices or E.uivalent Heaters KW o.of Data Wirin Si s Ballasts No.of Devices or E.uivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E.uivalent �� • U _) Attach additional detail i ed or as required by the Inspector of Wires. Estimated Value of Electrical Work (When required by municipal policy.) -� Work to Start:p /_.13_�0�, INSURANCE COVERAGE: Unless wabived by the requestedons to be wne permit in for the performance of e with MEC Rule eI and upon completion. the licensee provides proof of liability insurance includingelectrical work may issue unless t�^ undersigned certifies that such coverage is in force,and has exhibited proofr of same to the permit iscoverage or its suing substantial equivalent. The CHECK ONE: INSURANCE [ BOND ❑ OTHER g I certify, under the pains and penalties o perjury, ❑ (Specify.) FIRM NAME fp J ry,that the information on thisapplication is true and complete �z , t' ,s�. Licensee: ��— i is! -,•..v ! ••- ` 'e.`L s vt Z LIC.NO.: S 3 i ` C A ' c.✓ 0 Signature / .� (If applicable,enter"exempt"in the license number fine.) _ /" LIC.NO.: ',y 4 Address: . �y0 •y y0,,` L1J e,:/ e r� n Bus.Tel.No.: t _t �/ J *Per M.G.L. 147 s 57 61 security work requires D ,� ��Safety ! i�7 _ Alt.Tel.No.: OWNER'S INSURANCE WAIVER: � eparnnent of Public Safety"S"License: Lic.No. I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement I am the(check oneo 7 Owner/Agent 0 wrier ❑owner's a ent PERMIT FEE: $ al Signature Telephone No. -71)(,ic6 PA-ar s,11,1,11 �'lA--/Th" up 12tti0 (ems 1-1\1 E Cehbe-- &14 A-(2c- eke-be-Oen e/✓ lei c1sc atvi_ Fee- zitzaxij