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Home My WebLink AboutBLDE-23-005200 Commonwealth of Official Use Only Massachusetts Permit No. B0LDE-23-005200 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 Codc (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:3/22/2023 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 work described below. Location(Street&Number) 12 VERMONT AVE Owner or Tenant TORTOLA MONICA Telephone No. Owner's Address 1758 TRAPELO RD,WALTHAM, MA 02451 S1 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) ovid- Purpose of Building Utility Authorization No. (Z3 ✓/4 } Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters ✓Nit, New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade& relocate service. 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 ❑ 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 41N1 it, q/4/�3 RECEIVE D 1. Official U_,v Only ---__ rIAR 21 rnonwealth of Massachusetts permit No.:�`�— ZoU m.iqk=7 Department ofFire Services Occupancy and Fee Checked: "ml '' BOARDFOFERRE PREVENTION REGULATIONS [Rev.I/2023] ' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 CAR 12.00 City or Town of: YARMOUTH Date: /Z 1 23 To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the a ctrical work described below. Location(Street& umbe):/Z Vert-Malt 44 Unit No.: Owner or Tenant: / Email: Owner's Address: 7 j%(lYn/(/ Phone No.: 73 7 i f/ Is this permit in co junc on with a building permit?(Check appropriate box)Yes 0 No❑Permit No.: Purpose of Building: P/,c c4' / Utifty Authorization No.: Existing Service: hD Amps/Ls/740 Volts Overhead aU erground❑ No.of Meters: 1 New Service: -e/gyp Amps/Ze I7`'J Volts Overhead Underground❑ No.of Meters: I . Description of Proposed Electrical Installation: .Yr c4 `4 2 ,JP Ate Oita(AA, 41:244' rt /4/C. Completion of the following table may be waived by the Inspector of Wires. No.of Receptable Outlets: No.of Switches: Generator KW Rating: Type: No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating: No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: No.Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices: Swimming Pool:In-Gmd.0 Above-Gmd.0 Hot-Tub 0 No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices: No.Air Conditioners: Total Tons: Telecom System 0 No.of Outlets: No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: No.of Modules: Roof-Mount❑ Ground-Mount❑ Level I❑ Level 2 0 Level 3 0 Rating: OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work:1,066 (When required by municipal policy) Date Work to Start: /7J/�3� Inspections to_berequested in accordance with MEC Rule 10,and upon completion. FIRM NAME: !l,- e7_;NlLur"1 A-1❑or C-1❑LIC.No.: Master/Systems Licensee: LIC.No.:Journeyman Licensee://A(. 1V(t LIC.No.: 57`q T7-8 Security System Business regtliirres a 'visign of Occupation Licensure"S"LIC. S-LIC.No.: Address: 7 c'/ 6( e, Email: �/ne4AC'r, /Yt it C.O."' Telephone No.:(!f7 9Z7 c p7.a I certify,under I e and penalties of perjury,that the i ormat. !-lon on this application is true and co iee e.U G 'W ' Licensee: Print NameoZt41 0,AC n j -7/ l Cell.No p —i 0 INS COVERAGE:Unless waived by the owner,no permit 1d`'r the performance of electrical work may issue unless the licensee . provides proof of liability including"complet operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force and has exhibited proof of o the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 Specify: 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 0 Owner/Agent: Tel.No.: Signature: Email.: