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Home My WebLink AboutBLDE-23-002166 ® Commonwealth of Official Use only �. Massachusetts Permit No. BLDE-23-002166 1(\.4 � 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:10/24/2022 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) 17 BLACK DUCK LN Owner or Tenant MALZONE LOUIS F Telephone No. Owner's Address 67 UNCLE BARNEYS RD,WEST DENNIS, MA 02670 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: Install 3 smoke/CO detectors with wireless interconnect 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 Initiating 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 3 Totals: Detection/Alerting 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 Signs 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: MICHAEL F SIMONIS Licensee: Michael F Simonis Signature LIC.NO.: 16862 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 1488, EAST DENNIS MA 026411488 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 (Q6& (IP rnie 4 c i r L'vrh a /idt _ 114Ca tijOi2ff rD C_OB-i-k,s-- .7e1 7A-e_. i 1/Z6r a I/C-- —rt 73F tit I)E C'twpL , ) ( R€ ^ FIVFD t f1 OCT 21 /,� M� • t, oa,,, 1 _ Commonwaakk o`Maeaer'ivaaio / p u -u r c-A cc77 [ Permit No. L,v -- 'I o ! 1Japarlmeni o/Jire Services Occupancy and Fee Checked I` "\J BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) v APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK lei All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 ,11 (PLLASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /o/Z>/Z Z City or Town of: }f-.4-.-r..�1Z-A, To the Inspector of Wires: n By this application the undersigned gives notice of his or her intention to perform the electrical work described below. 1 U Location(Street&Number) /7 Z. G,f-4,l_ . ri 4.-,, 4%4•1 e- Owner or Tenant .,p v .47,-/2 m H e Telephone No. Owner's Address S-f-ay'C. Is this permit in conjuuctioa with a building pes' lt? Yea ❑ No Li (Check Appropriate Box) U Purpose of Building SAN/We ,' t-r+-t/y 7,u/C,/l� Utility Authorization No. u Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters i New Service _ Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampaclty "I Location and Nature of Proposed Electrical Work: ye,o�.f../i(3) �.Fr,5/ ',e_s s iiie e%F ee ,.Z.El-,-4-/'c .e',z -Tt0 S. vo,he C./ea .7,-c.. -7 2,s V) Completion of the following table m y be waived by the/+rector of Wires. WNo.of Recessed Luminaires No.of Cell:Snap ns.(Paddle)Fans Tr.of Total TrTransformers KVAVA CI No.of Luminaire Outlets No.of Hot Tubs Generators KVA ca Above In- No.of Emergency Lighting 4. No.of Luminaires Pool grad. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones d No.of Switches No.of Gas Burners No.InDeteon v InitiatingInitiatingntig Devices i No.of Ranges No.of Air Cond. Tonsi 'No. of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Pa Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑Connectioon ❑Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent 17,.7.'Water ? N .of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Wiring: No.Hydromassage Bathtubs No.of Motors Total HP Tei communicati No.of Devicesons or Equivalent OTHER: Attach additional detail if desired or m required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start:/O 7a ., Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE GE: 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 0 OTHER 0 (Specify:) i.i•vwi- /e -s I certify,under doe pains and penalties of peeing,that the inforaoadon on this application is true and complete. FIRM NAME: 5,wz ,-w -5 /c _�ir e_ LIC.NO.:.4/6 edti2.- Licensee:*.e.4l rt/. 'vsoo�5 5igaataryy% _ .... - LIC.NO.:Fad'2 (I I apolicable,enter"enempt"in the license number fine.) % Bus.TeL No..SDg 8 f�667 Add ess:/°O•��X /Y " �- aendVis H?,1• ' ° 04/ Alt.TeL No.: 'Per M.G.L.c.147,s.57-61,security work requires Deparmmen{of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hove the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. 1 am the(check one)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$_SD•ce