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Home My WebLink AboutBLDE-23-003398 &C� Commonwealth of Official Use Only Permit No. BLDE-23-003398 i'',%► "�` Massachusetts ECOARD 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 Elec 'cal Code (MEC),527 CM, 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) D te:12/19/2022 ). 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 cscribed below. Location(Street&Number) 5 LOOKOUT RD Owner or Tenant ARPANO MICHAEL A Telephone No. Owner's Address ARPANO SHARON, 5 LOOKOUT RD,YARMOUTH PORT, MA 02675-1015 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: Portable generator. 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 SwimmingPool Above 0 In- ❑ No.of Emergency Lighting No.of Luminaires grnd. 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 ❑ Other: No.of Dishwashers Space/Area Heating KW Local 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 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: 12/19/2022 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: COTTI JOHNSON HVAC Licensee: Jason Mienscow Signature LIC.NO.: 22630 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:36 Torrey Road, Cumberland RI 02864 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 I // inn M // Official Use Only ' Commonwealth o f amachusetts '+*=_ _ 1 c� Permit No. Z 3 - 3 i.✓ eCJepartment o� ire�erviceo ,,Ts. __1=`— 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 Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: \ /O,/a City or Town of: `(C:,.r•c-.,Gv4\-, 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) t� \ C"/ 00, cd Owner or Tenant c 1 ‘C,heu\ P\!-VGL Nt�0 Telephone No. 5 OK -5 i'V Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑l (Check Appropriate Box) Purpose of Building C E, Jl CA-0,1A'!G Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd In No.of Meters New Service Amps / Volts Overhead El Undgrd El No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: t tom\-c.t I\ ?cc k-Ci'o e �t,-,{�ctc-O c bC bk,.. Sc ce .1 lac;!-, ,,,-,,,\call C,v v,01-e, r,o ry-,e. s oCg-e v CO\- f( l,cu\ -J 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 No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners 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 Other No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ HeatingAppliancesSecurity Systems:* No.of Dryers KW No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters Signs KW Ballasts 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: ,R., ; (When required bymunicipal policy.) � :C�� .CCU q p P Y• Work to Start: 1 1.ic,\,/,),� 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: Cott'Johnson LIC.NO.: 2630-A Licensee: Jason Mienscow Signature %2 LIC.NO.:12025-B 77 0 (If applicable,enter "exempt"in the license number line.) / Bus.Tel.No.: Address: 30 Waverly Street,Taunton,MA.02780 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 I PERMIT FEE: $ v Signature Telephone No.