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Home My WebLink AboutBLDE-21-006044 Commonwealth of Official Use Only Permit No. BLDE-21-006044 EL F, 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:4/21/2021 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) 326 STATION AVE Owner or Tenant Verizon Telephone No. p( Owner's Address 326 STATION AVE, SOUTH YARMOUTH, MA 02664 n'�(ir`� Is this permit in conjunction with a building permit? Yes 0 No ❑ (Cheek Appropriate Box 1(/"" ` ( Purpose of Building Utility Authorization No. 220262>8 / r Existing Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters //y New Service 100 Amps Volts Overhead RI Undgrd 0 No.of Meters vvv Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Service to pole mounted equipment. 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 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 0 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 Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: Y g 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: Shawn Ventura Signature LIC.NO.: 22687 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:73 Fieldstone Drive, Coventry RI 02816 Alt.Tel.No.: 7748041517 *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 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: $80.00 I it's, co,.........im 4 Inamachamits Official Use Only x. `_ `' c� �/ Permit No. �� b o `�ci w .1�apaPiaMat 7 e ; ' Occupancy and Fee Checked BOARD 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(ME ),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Li 2c, 2 City or Town of: YC.rw.o,v4-(ek To the Inspe for of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 3 Z c. .5�t-h►-k-�'uv-, Au-e_ S. YGCw.v vi-n. Owner or Tenant 5ers-<<c_ (y V lt\--c Pa Le_) Yr 2%(S(o Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Ufa%II pc, Utility Authorization No. 22-0 2(c 2 l; Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service too Amps fo / Zhc) Volts Overhead Undgrd ❑ No.of Meters ( Number of Feeders and Ampacity 3 (#- - c_`, Location and Nature of Proposed Electrical Work: 0hg�v,..t` ticw lc.)o.4- S-e-c'uec..-e` 0-, V`rilNi fts‘a- kir 2y IS(o •Cor cwe %l von 4e.t,"p it c itA10 $s-. Completion of the followingtable may be waived by the Ins ctor of Wires. No.of Recessed Luminaires No.of Ceil.-Snap.(Paddle)Fans No.of'1 Inspector Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above ❑ In- ❑ No.of Emergency Lighting No.of Luminaires Swimming Pool grad. grad. 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 Na of Waste Disposers Heat Pump Number Tons , KW No.of Self-Contained Totals:_ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other Cyonaection No.of Dryers Heating Appliances KWSecurity N of Devices or Equms:* ivalent No.of Water KW Heaters Signs Ballasts No.of Devices of No.of Data Wiring: evices or Equivalent No.Hydromassage Bathtubs Na of Motors Total HP Telecommunications Wiring No.of Devices or Equivalent OTHER: Attach additional detail if desirec4 or as required by the Inspector of Wires. Estimated Value of lectrical Work: k. .`, " (When required by municipal policy.) Work to Start: k-k L3 c 2...2` 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 T5 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: k-kezc c.e C 00.A.04.-�.e�4-u uv. 5 LIC.NO.: '22(o 8 7,t Licensee: S wt^ 0.e*0lr.v,r,,v, Signature / (.2 �,,, LIC.NO.: (If applicable,enter"exempt"in the license number line) Bus.Tel.No.:77V^9 a Y-/S/7 Address: 1 w�w.cwvk. ww-y get.V.r t VY-wt. AAA. CI? o( I Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security 1work requires Department of Public Safety"S"License: 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 agent. Owner/Agent Signature Telephone No. `PERMIT FEE:$