HomeMy WebLinkAboutBLDE-23-004831 � y Commonwealth of Official Use Only
L., Massachusetts Permit No. BLDE-23-004831
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) 6 FRANCES HELEN RD
Owner or Tenant REGALBUTI ARMAND TR PERS REP Telephone No.
Owner's Address C/O GEORGE THOMAS&ALICE TRS, 17 THATCHER SHORE RD,YARMOUTH PORT, MA 02675
Is this permit in conjunction with a building permit? Yes ❑ No ❑ (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: Install 3-hard wired 10 smoke detectors in the bedrooms and 1-10 year CO/Photo
smoke in the hallway.(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 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/Alertine 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 Siuns 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: P. O. BOX 762
Licensee: JOHN B RAIMO Signature LIC.NO.: 51195
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:71 NEARMEADOWS RD, DENNIS MA 02638-0000 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:$50.00
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€Vil BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PALL SE PRINT IN INK OR TYPE ALL INFORMATION) Date: 3.1.23
®� W City or Town of: Yarmouth To the Inspector of Wires:
LJ.I N By$hn application the undersigned gives notice of his or her intention to perform the electrical work described below.
c�.,i Liiial on(Street&Number)6 Francis Helen Rd
a
w �O O ne or Tenant Chris George Telephone No. 508.310.3021
�
f Q OWn 's Address
.•. M 'Si i permit in conjunction with a building permit? Yes ❑ No Ti (Check Appropriate Box)
Plmp�.e of Building Dwelling Utility Authorization No.
g Service Amps / Volts Overhead n Undgrd ❑ No.of Meters
New Service Amps / Volts Overhead I I Undgrd I I No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install 3-hard wired 10 Smoke detectors in the bedrooms and
1-10 year CO/Photo smoke in the hallway. Install arch fault breaker for the effected circuit.
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 1-1 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. TonsTota
No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
l J Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of Devices or Equivalent
No.of
No.of
HeatersK�'�' Data Wiring:
Signs Ballasts 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: $1000 (When required by municipal policy.)
44 Work to Start: 3.2.23 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
t J the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
a undersigned certifies that such coverage is in force, and has exhibite oof of same to the ermit issuing office.
CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ ( eci :)
3) I certify,under the pains and penalties of perjury,that the info atio on t ' is ion is true and complete.
R"3 FIRM NAME: Raimo Electric LLC LIC. NO.:a18352
Licensee: John B Raimo Signature
t .8 �� LIC.NO.:e51195
(If applicable, enter "exempt"in the license number line.)
Address: Box 762 Dennis,MA 02638 Bus. Tel.No.:508.725.7259
(_.� *Per M.G.L. c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Alt Lio 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. I PERMIT FEE: $ I