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Home My WebLink AboutBLDE-23-001852 v Commonwealth of Official Use Only j Massachusetts Permit No. BLDE-23-001852 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:10/6/2022 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) 29 PAINE RD Owner or Tenant PAGLIARULO GEORGE J Telephone No. Owner's Address PAGLIARULO MICHELE, 3 R OLD COACH RD, HUDSON, NH 03051 '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 tOverhead 0 Udg 4e,,Ao Of,Me New Service Amps Volts Overhead 0 Undgrd l; tx l ,ofM[e, s Number of Feeders and Ampacity �, fF` ..s i ip .-Location and Nature of Proposed Electrical Work: Permit to close out expired permit(E20-1124) a s , N 1 Completion of the following table hp Nddir''`a w by,the l p`ector of Wi No.of Recessed Luminaires No.of Ceil: No.of "'. Susp.(Paddle)Fans ! 1 " t.„, Total Transformers ,,,, j>`� KVA No.of Luminaire Outlets No.of Hot Tubs Generators )KVA . No.of Luminaires Swimming Pool g bovend. 0 grnd. ❑ No.of Emergency Lighting r 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 Ton 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 0 Municipal 0 Other: Connection _ No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts Data Wiring: Siens 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 I ^_;.4�,r- ,La 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 tissue 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 Telephone No. PERMIT FEE: $50.00 g4 CornmontvaatUt "� f�,1*/ �e�"'ade�auep� Q_ffieial Use Only u'~ v apartmsni ol,firs Permit No. t �C 6 5� � - ` 7ARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev. 1/071 leave blank -------^ f APPLICATION FOR PERMIT TO PERFORM ELECTRICAL IRr~ All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CL WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: YARMOUTH Date: To the By this application the undersigned gives notice of his a in entr no o perform the electrical workdes r• ibed below. Location(Street&Number) ow Owner or Tenant r Owner's Address II Q i 7C Telephone No. Is this permit in conjunction with a building permit? y� � rc. L ty ❑ (Check Appropriate Box) Purpose of Building Existing Service Utility Authorization No. Amps / Volts Overhea :..��w: rvice U' Volts Overhead❑ Undgrdadgrd 0 No.of Meters Number of Feeders and gmppdty El No.of Meters Location and Nature of Proposed Electrical Work: 02 —�_✓c7 r o a dy c' r�u No.of Re Com,knon o the ollowin:table may be waived b the In ,ector o Wires. n0 ceased Luminaires No.of Cell:Sna . °O.o No.of Luminaire Outlets P (Paddle)Fans / Transformers ota No.of Hot Tubs 'A -' No.of Luminaires Generators KVA Swimming Pool ,rindv.e ❑ n- 'o.o mergency g ng No.of Receptacle Outlets ' d. ❑ Batte Units g -�� No.of 011 Burners FIRE ALARMS No.of Zones v No.of Switches • t r ,3 No.of Gas Burners °o.o i etec on an No.of Ranges ota Initiatirb„Devices No.o Mr Cond. No.of Waste DisposersTons No.of Alert eat ' ' ' „ Alerting Do-vices S ump um er ons of o e -Lizartra aaEw Totals: ..._..____._..., ..pus__. No.of Dishwashers DetectionCN.!e xln�r Devices Space/Area Heatingices KW $rexie��;�No.of Dryers Local❑ C rr 4. y `r 1 0 Met `o.o "a er Heating Appliances K�, ecunty b ate. , 1 Heaters KW `o.o `o.o No ofefr . t trialetrt No,Ayd He aasage Bathtubs Si:us Ballasts Data Wiring; No.of Motors No.of David,c,, i intent OTHER: Total HP a ecomnrrtrr w dtaatts"` lrris -- ---_ No.of FA �tie ne. itiveicnt Estimated Value of Electrical Work: Attach required additional detail i ed,or tzr rc x ae'r e y; f1e l,t tot Starr —Q- (When required by municipal policy,) PQctor of Wires. WorkSURANCE CO Inspections to be requested in accordance with MEC Rule 10,and upon completion. INCOVERAGE: Unless waived by the owner,no permit for the performance of electri-cut work may the licensee provides proof of liability insurance including"completed operation"coverage or undersigned certifies that such coVerage is in force,and has exhibited proof of same to the permit y issue unless CHECK ONE: INSURANCE g its sutiM-tarsiiat equivalent. The I cerdA,ONE: the URA.ains d 0 BOND ❑ OTHER 0 (Specify:) S ci p rmrt issuing office. penalties ofperJury,that the Information it this application is true and complete. FIRl►T NAME: Licensee: (Ifapplfcable,enter"exempt"in the license number line.) Signature LIC,NO.: Address: LIC.NO.: 1~— AddM.G.L.c. 147,s.57-61, This.Tel. OWNER'S INSURANCE a. security work requires De No. �"" CE WAIypR: Department of Public Safety"S"License: Alt'Tel.No.: Owner/Age by law i am aware that the Licensee does not have the liability insurance coverage n Lic.No. required ! my sign a ow, hereby waive this requirement. I Signatur am the(check one / owner y Telephone No. o" — owner's a:ent. / PERMIT FEE: