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Home My WebLink AboutBLDE-22-006353 Commonwealth of Official Use Only :it-1U .' Massachusetts Permit No. BLDE-22-006353 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:5/3/2022 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) 122 LEWIS RD Owner or Tenant Greg Renata 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: Dress up wiring in basement&prep for new ceiling.Add recessed lights. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires 10 No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 Ian,.-nd. ❑ No.of Emergency Lighting grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No.of Switches Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices ❑ Municipal No.of Dishwashers Space/Area Heating KW Local Connection ❑ Other: 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 Signs 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 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: Richard L Serpone LIC.NO.: 6910 Licensee: Richard L Serpone Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line) Alt.Tel.No.: Address: 183 PINE ST,YARMOUTH PORT MA 026752374 *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 I PERMIT FEE: $80.00 Signature Telephone No. V--gli:›‘->Co4i Cr 4Joit dk ) gY,C(t74v l' _„ Comnwnwaa&�ai�`(01 490.0daChl444110 Icial Use Only c� c7 Jn�7 Permit No. ti,:i 1itt 2spartmsnf° rs arvtcsd r ;""MPw„ 11' BOARD OF FIRE PREVENTION REGULATIONS Occupancye . / and Fee Checked + ,, ( (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with thy Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,�) ,Z.Z 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) /a Le cv/S jai r Owner or Tenant i4 qt. Telephone No. Owner's Address e i'S aot,e._ Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) ii Purpose of Building /)the L/r t1-73 Utility Authorization No. Existing Service /ea Amps /, / /molts Overhead 2— Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity - jj Location andte Naturen of Proposed Electrical Work:f or, c IIN' t cer 1Pi Obvp1--Q llliy writ t J'ecsrevill / ecgd, �.vtNtt N /feceSSe""c' fi'9/Ll�s� 4f/ -et- t.t/4req I:5 e�tis7/i" ft7 "i' 7 CoYhpletion of the followin&table m be ward by the Inspector eWires. t-.,f L, No.of Recessed LuminairesNo.of Ceil:Susp.(Paddle)Fans No.o Totals ,, ,-,,� /0 Transformers KVA 'Z No.of Luminaire Outlets No.of Hot Tubs Generators KVA r^, -t No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting grnd. ❑ grnd. ❑ Battery Units y No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and <c _ Initiating Devices 't' No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting_�Devices MNo.of Dishwashers Space/Area Heating KW Local 0 Connection ❑ Other Connection No.of Dryers Heating Appliances K Security Systems:''No. No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Sins Ballasts g No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent -,„,N,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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) I certify,under the pal Ind renal,of per ry,that the information on this application is true and complete. A. 9)p FIRM NAME: / , kpp ekeL (' LIC.NO.: Licensee: f r it Signature/414,41_0--ft, LIC.NO.:A/64yt' (If applicable,enter"exempt"in the lice a umber line.! �/ Bus.Tel.No.,09£r-34 —)79,�f Address: /� - Ae'uc 5 As/ (,vog t r1a,,cs4 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. 1 am the(check one)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$