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Home My WebLink AboutBLDE-23-004176 of Commonwealth of Official Use Only : ,' Massachusetts AC11\ Permit No. BLDE-23-004176 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:1/27/2023 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) 10 MIDDLE RD Owner or Tenant GAZZOLO DAVID P TRS Telephone No. Owner's Address GAZZOLO VIRGINIA J TRS, 10 MIDDLE RD,WEST YARMOUTH, MA 02673 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: Wiring for new pantry. 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 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/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 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 perjuty,that the information on this application is true and complete. FIRM NAME: Gregory J Dailey Licensee: Gregory J Dailey Signature LIC.NO.: 40728 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 113 BRENTWOOD CIR, PLYMOUTH MA 023601000 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 oltneti- 2/Cti 73 le '2- . 'AApli. •.. , ,.._ • C.I.D.# 7 F C E V 0. o • fin o/tY/a33acheuee113 Official Use Only _ =1AN 2 6 2023 cc77 Permit No. ��l '�"�� ( �P C__`:_�_ 9 ep,'Intent oi5re Service3 ;. -'`LF1 R Occupancy and Fee Checked -- SPA PREVENTION REGULATIONS :. ! � DING�9t'P'�KT`Pk� [Rev. i/07] (leave blank) BY -- -- . _ ION OR 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/ �lU City or Town of: I�,i `1 min oath o 1 t�`1 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) I 0 /i,d ci(e Rol_ Parcel ID: Owner or Tenant )c o i ot, � oi/ e)Q Telephone No.7 '/- l) -a))/ Owner's Address I D /")i Is this permit in conjuntion with 1 building permit? Yes [31 No ❑ (Check Appropriate Box) Purpose of Building 11 t°'; eh ri,mj Utility Authorization No. Existing Service 100 Amps /)-O / ),4dVolts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of feeders and Ampacity Location and Nature of Proposed Electrical Work: n/•e k' P010-7 rao w 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 DNo.of Switches No.of Gas Burners No.inittiat °Devi es No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Hot Pump Number Tons KW No.oThelf-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal _ � Connection 0 Other No.of Dryers Heating Appliances KW Security Systes:* No.of Devicesm or Equivalent No.of Water KW No.of No.of Data Wiring Heaters Signs Ballasts No.of Devices or equivalent - No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: #1,0 0 C. Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lectri al Work: f , ,y,(i),/ (When required by municipal policy.) Work to Start: 6 2.3 Ins. ctions to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO ER GE: 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 BOND ❑ OTHER ❑ (Specify:) I certify,under the ins and penalties of perjury,that the information on this application is true and complete. Is FIRM NAME: 6reyor Dot`I•r7 Elittrl`tj , LIC.NO.: l-I07).q Licensee: 6 r or rai I / Signature Y.`)i Z LIC.NO.: (If applicable,enter e / -7 y pt"in the license numb r line.) Bps.Tel.No.: 7 fit'7 33_)331 Address: 113 Is(ivirt%va of Giro_,. I'I7►M1,v 0,-/A1 /y/4 0 d U0 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 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. 1 PERMIT FEE:$