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Home My WebLink AboutBLDE-22-007096 Official Use Only ,,.. Commonwealth of L 'tx,1 ---1) i Massachusetts Permit No. BLDE 22-007096 ' emu, ),' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.t/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) 311 GREAT ISLAND RD Owner or Tenant Scott Lipnick Telephone No. Owner's Address 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: Rewire first floor&wiring for second floor addition. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- ❑ No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grnd. Battery Units No.of Receptacle Outlets 28 No.of Oil Burners FIRE ALARMS INo.of Zones No.of Detection and No.of Switches 12 No.of Gas Burners Initiatine Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Ton Heat Pump I Number I Tons KW No.of Self-Contained 9 No.of Waste Disposers Totals: Detection/Alertine Devices Local 0 Municipal 0 Other: No.of Dishwashers Space/Area Heating KW Connection Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Shins No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs :No.of Motors Total HP 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 pennit 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: LIC.NO.: 56013 Licensee: Alex Nieves Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel No.: o. Address:92 Smith Street, New Bedford MA 02740-5355 *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: S180.00 OF 1 65j.kaae_6mid pRowriv ‘ ue.v part- 0.9/74, I2K GD 0 E-,(3 e...0 frg- `'- SUN 07 20ZLe motLA el Maesach eite Official Use Only �/ i c� �7 Permit No. LZZr-10? NT n1° irs Jawicsa II:- 4 LDING DEPART �--��`` Occupancy and Fee Checked J 't ,�._. ----.BOARD OF F1RE�REVENTION 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(M ),5 7 CMR 12.00 !, (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Col 7 2-- To City or Town of: YARMOUTH To the Inspecto. of Wires: By this application the undersigned ivies notice of his or/ her intention to perform the electrical work described below. t Location(Street&Number) '(Id �rCct I-" _Ts"/4 0,,i / Owner or Tenant So--- L,e v,.i c(L Telephone No. v `� Owner's Address ,3(( G rt.-� -S(c 2.0 T Is this permit in conjunction with a building permit? Yes ❑ No r (Check Appropriate Box) \`` Purpose of Building i�S t Utility Authorization No. 'U Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters pe New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature/of Proposed Electrical Work: g,C fin✓�) w\r; 4-Li w.-S �4 o, o✓` ,r,cs t "PIc'dr ?coo:tki `, ri S 4J S1'u`- 0,-o-d;4-iav,. No Completion of the followinelable m be waived by the Inspector of Wires. tik No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.off Total 0/ Transformers KVA =.1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA rA ove ,t No.of Luminaires '� Swimming Pool QAbrnd. ❑ In-grnd. ❑ No.of Emergency Lighting Battery Units . No.of Receptacle Outlets 0 No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and .. No.of Switches i' No.of Gas Burners Initiating Devices 1 r No.of Ranges No.o/Air Cond. T Totans No.of Alerting Devices No.of Waste Disposers Heat Pump limber Tons KW .No.of Sell'-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other, Connection No.of Dryers Heating Appliances KW Security * f Devices or Equivalent No.of Water No.07 No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Tel No.of Devicesons or Equivalent OTHER: (1) i/ Srb[4 5 Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 4'a./J (When required by municipal policy.) Work to Start: 6;. 7/Z Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: 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 _v ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE/NIS- BOND 0 OTHER 0 (Specify:) I certify,under the ains and penalties of perjury,that th information on this application is true and complete. FIRM NAME: J�tt il.), -(v j K/-&c.- ,c i a,-,�� LIC.NO.:,__ Licensee: �� D)i�,v,S Signature a�`�`"�� LIC.NO.:5-6 O l 3 (If applicable.enter"exe pt"'in,!tithe license-�'j'mbe(r 1' e.) Bus.Tel.No. 7`i 9 2'I Address: Cr',Z Sim•7k �7r' � `"� / , f 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)❑owner ❑owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.