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Home My WebLink AboutBLDE-23-003681 -y-= Commonwealth of Official Use only �` i11 Massachusetts Permit No. BLDE-23-003681 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:1/6/2023 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 wor escribed below.� �Location(Street&Number) 12 VERMONT AVE Cjj 't�Y2 f t C(V < ] Owner or Tenant T A Telephone No. Owner's Address 175 ,_W.At Tun.4_se4n21 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: Bonding to re-bar. 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 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: Licensee: Zachary Mancini Signature LIC.NO.: 57951 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:45 Taft Road, West Yarmouth MA 02673 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 RECEIVED '' A N 0 51013 /"" ° °°°a`�`"°'h° Official Use Only , ,-- «'t ��bbb �'i p Permit No.Ea3 -3cO�( •r.•�a_}}yNG DEPARTMENT nI al ine:linked ', 1's� •e-e. -F1' PREVENTION REGULATIONS Occupancy 1/07) and Fee Checked �� [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 JV (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Dater/r/2S City or Town of: YARMOUTH To the nspector of Wires: By this application the undersigned gives notice of Lis o her intention to perform the electrical work described below. Location(Street&N ber)/2 //'I/lZ1h` ( 44,4ef/- C. Owner or Tenant // v'yneaLI Telephone No. Owner's Address/7 ✓C1 , ilvc,G✓ - /iflcL/ Is this permit in conjuu gtlon�"w"with a byilding permit? Yen ❑�No ❑ (Check Appropriate Box) `.. Purpose of Building/mac ( 1 r/Yn rPo g J! Utility Authorization No. v Existing Service JOU Amps /2'/Z"t^ Volts Overhead Er Undgrd❑ No.of Meters C New Service ?� Amps /L /Z`'(° Volts Overhead Er Undgrd❑ No.of Meters Number of Feeders and Ampaclty / Location and Nature of Proposed Electrical Work: ,v,L✓u f, 8o,.l,/ A 4�� • Completion of the followingtabk mcry be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ce1L-Sallo.of Total ni ep.(Paddle)Fans Transformers KVA nNo.of Luminaire Outlets No.of Hot Tubs Generators KVA ,it- No.of Luminaires Swimmin Pooi Above In- No.of Emergency Lighting g end. ❑grnd. ❑ Battery Units �1 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 III No.of Ranges No.of Air Cond. Totaln No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: ............-"'.................... Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑Cnnecptlal a ❑she. No.of Dryers Heating Appliances KW No.o Systems:. Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters Sys Ballasts No.of Devices or Equivalent No.Hydromaauge 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:�Q9 (When required by municipal policy.) Work to Stan: //i/7 3 Inspections to be requested in accordance with MEC Rule l0,and upon completion. INSURANCE O RAGE: 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 0 OTHER 0 (Specify: I certify,under th I s and penalties�pJjpp/etcrjury,tha!t a information on this application is true and complete. ,((��FIRM NAME l=� CS'1. G cfj.2,'t^ LIC.NO.: 7 7$ l-CJ Licensee:0( �' Y"`c.ti, Signatures MC.NO.: (lfapplicable'Snier' env!:tnQje,license number line.) Bus.Tel.No.C/ —c"/79'`r' 76 Address: r /a /CL-/ 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$