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Home My WebLink AboutBLDE-22-007095 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-007095 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:6/7/2022 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) 17 SATURN LN Owner or Tenant TANNOZZINI ROBERT Telephone No. Owner's Address TANNOZZINI SANDRA, 49 WALNUT ST, MILLIS, MA 02054 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 split A/C. 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 ❑ Lt- 0 No.of Emergency Lighting grnd. 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. 1 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 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: Michael J Chase Licensee: Michael J Chase Signature LIC.NO.: 20654 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 19 MAYFAIR RD, SOUTH DENNIS MA 026602903 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"Licens OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liabil' j r•- e core nor Ily required by law.But my signature'below,I hereby waive this requirement.I am the(check one) ❑ .' - 0 • sy • • . e Owner/Agent o 4 f i� Signature Telephone No. o8 L �i T FrE: $50.00 0 Commonwealth o/Maeoachuoetts Official Use Only .= l Permit No. --tit 1 2)epartmenl o/.)ire Servicee 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 Co ( EC) 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7�ac __. City or Town of: Yi+ - 4 0174 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) 1 7 5A-To J t--"C- Owner or Tenant po b -Thu-}t N.t.)O z.Z.l 0 i Telephone No.,. 5j-3 3(-6 I CO Owner's Address 1 7 SA-yu c. € Si r i Li7Y /l1fr 0-4 l Is this permit in conjunction with a building permit? Yes ❑ No EL (Check Appropriate Box) Purpose of Building S(a - -t ert Utility Authorization No. Existing Service Amps / Volts Overhead n Undgrd❑ No.of Meters New Service Amps / Volts Overhead n Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: L i ram-- tl.,t.d,.J AA, es-,'wr Sl(;'T Completion of the following table may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf 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 of No.of Switches No.of Gas Burners No. Initiatinnggon Dete and In Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of DryersHeating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications NofDevices orWiring:q al Y g No.of Devices 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: 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 [ - BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: I LEC-4,R---1 C .T)c--_ LIC.NO.: I Lirti 4 Licensee: /I - Gam' Signature 9.-dam`��' e`"" LIC.NO.: 26.c`:I'(- (If applicable,enter "ex t"in the license numb line.) Bus.Tel.No.: C5+f.'341'Tot( Address: P4 , o nil'?K 'i ' JJ /kW 0.40 Alt.Tel.No.: SM')-`1S-=-3e10 *Per M.G.L. c. 147,s. 57-61,security work requires Depaftment 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 PERMIT FEE: $ Signature Telephone No.