HomeMy WebLinkAboutBLDE-23-004830 `or Commonwealth of Official Use Only
fi Massachusetts Permit No. BLDE-23-004830
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:3/2/2023
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) 40 DEBS HILL RD UNIT 3B
Owner or Tenant LOWENTHAL ARLINE TR
Telephone No.
Owner's Address THE ARLINE LOWENTHAL TRUST,40 DEBS HILL RD UNIT 3B,YARMOUTH PORT, MA 02675-2530
Is this permit in conjunction with a building permit? Yes 0 No 0
Purpose of Building (Check Appropriate Box)
Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0
New Service AmpsgNo.of Meters
Volts Overhead 0 Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install automatic 100a transfer switch and generator(508-725-7259)
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 I No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
No.of Ranges Initiatine Devices
No.of Air Cond. Total No.of Alerting Devices
Ton
No.of Waste Disposers Heat Pump I Number I Tons KW No.of Self-Contained
Totals: Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal
Connection 0 Other:
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water K� No.of
Heaters No.of Ballasts Data Wiring:
Siens No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
OTHER: No.of Devices or Equivalent
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: P.O. BOX 762
Licensee: JOHN B RAIMO Signature
LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 51195
Address:71 NEARMEADOWS RD, DENNIS MA 02638-0000 Bus.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.:
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.
I PERMIT FEE:$50.00 I
C
C —tCk 3/'/ C- r
+ �- C.oinmoiewealth o �j
*=-_ratiiii,"M t `rr/addachuaslia Official Use Only
"�+1_-_- -Ueparfntertt 4 ire Serviced Permit No. L�� ' 3 " /
w� l_I_
f = BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
.. [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
' ASE PRINT IN INK OR TYPE ALL INFORMATION
CI z City or Town of: Yarmouth To Date: 3.1.23
uj '1'y is application the undersigned gives noticectoropvire
e of his or her Intention to performthe electrical work described below.
N po u i tion(Street&Number)40 Debs Hill RD
""'l cat er or Tenant Arline Lowenthal
LU o ' I i er's Address Same Telephone No.
ex
C)1 Cr o I is permit in conjunction with a building permit? Yes
Ll1j F'u I ose of Building Dwelling ❑ No ❑ (Check Appropriate Box)
Utility Authorization No.
'EA ting Service 100 Amps 120 /240 Volts Overhead
❑ Undgrd® No.of Meters 1
New Service Amps / Volts Overhead
iity ❑ Undgrd 0 No.of Meters Number of Feeders and Ampac
Location and Nature of Proposed Electrical Work: Install Automatic 100a transfer switch and generator. Transfer
switch will be located to the right of the electrical panel and the generator itself will be located adjacent to the back deck.
Com.letion o the ollowin_ table mo be waived b the Inspector o Wires.
No.of Recessed Luminaires No.of Ceil: p.(Paddle)Fans
No.o
ansformers Total
No.of Luminaire Outlets No.of Hot Tubs KVA
Generators KVA
No.of Luminaires Swimming Pool Above ❑ In-
`o.o mergency ig, mg
rnd.
No.of Receptacle Outlets rnd. Batt, Units
No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
No.of Ranges Initiatin. Devices
No.of Air Cond. Total
C9 No.of Waste Disposers
Tons KW No.of Alerting Devices
,i3
He
at Pump Number Tons Totals: No.of elf- ontamed
No.of Dishwashers I Detection/Alertin. Devices
Space/Area Heating KW Local❑ Municipal
No.of Dryers HeatingAppliances Connection ❑ Other
PP Kam, echo.o ystems:
o.o Water No. of No.of Devices or E•uivalent
Heaters KW No.o Data Wiring:
Si ns Ballasts No.of Devices or E I uivalent
No.Hydromassage Bathtubs No.of Motors Telecommunications or Wiring:
cg Total HP g
OTHER: No.of Devices or E i uivalent
Estimated Value of Electrical Work: $13,000 Attach additional detail if desired, or as required by the Inspector of Wires.
Work to Start:3.ti.23 (When required by municipal policy.)
d in
INSURANCE COVERAGE: Unlesspections to wai waived bybe the owner,nopermit or the nce with
r o anceRu el and upon completion.
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.
p nce of electrical work may issue unless
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuingoffice.
CHECK ONE: INSURANCE The
❑ BOND ❑ OTHER El (
I certify,under thepains and penalties o `t n')
p f perjury,that the infor ,i n o t '
FIRM NAME: Raimo Electric LLC P� cation is true and complete.
ti J Licensee: John BRaimo iLIC.NO.:A18352
t (If applicable, enter "exempt"in the license nu Signature mar
Address: Box 762 Dennis,MA 02638 tuber line.) LIC.NO.:E51195
*Per M.G.L.c. 147,s.57-61,security work requires De Bus. Tel.No.:506.725.725s
el.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the License:i insurance nc No.:
Department of Public Safety"S" Lic.No.liabil
Owner/Agent
req ner/ g law. By my signature below,I hereby waive this requirement. I am the(check one
Ownred by la e coverage normally
Signature El owner El owner's a_ent.
Telephone No. PERMIT FEE: $