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Home My WebLink AboutBLDE-22-007123 1 •,.� ;, -Y CCommonwealth of Official use only Massachusetts PenmitNo• BLDE 22 007123 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:6/8/2022 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) 65 GRANDVIEW DR Owner or Tenant Jim Foltz Telephone N . Owner's Address 65 GRANDVIEW ST, SOUTH YARMOUTH, MA 02664 ",�� 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: Relocate dryer receptacle&install 20 amp circuit in basement. Completion of the following table may be waived by the Itidector 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 0 tn- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FiRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatintt Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent 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 petjury,that the information on this application is true and complete. FIRM NAME: John B Raimo Licensee: John B Raimo Signature LiC.NO.: 18352 (If applicable.enter"exempt"in the license number line.) Bus.Tel.No.: Address:71 NEARMEADOWS RD, WEST YARMOUTH MA 026735009 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,1 hereby waive this requirement. 1 am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 [II ECEIVEDI JUN 0E2022 ' n 0.' /yy�� Jl.ommonweaUh°!trladdachiadetld Offsccriall Use Only 2 BUILDIN e' -,w..a A"-NT : c-A �c�-71 n Permit No. (y-7i 2-3 By- - �1.--A,.- __-_, eparimenl o Jier Serviced .11-- 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 aco moose with the Massachusetts Electrical Code MES),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I,(< D_ City or Town of: YARMOUTH To the Ins ector of Wires: By this application the undersigned giveiootTce of his or her intention to perform the electrical work described below. Location(Street&Numb r) (p, p 1� a'cru cX l)�'�:a �c Owner or Tenant,.J `yam Telephone No. - Owner's Address skByGjyt,_� _ 3� Is this permit in conjunction with a bu[Iding permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building-- .n---9,..A.�� Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty tt nn �__ Location and Nature of Proposed Electrical Work: ` t - Q c CSo c 9_S kt r Nav (�l It _Q 1� Lin ) `itc({*i/C1J 1 iLr�� 1 [Rf¢:,.A vrt ' Completion of the followin&table may be waived by the Inspector of{Wires. Us No.of Recessed Luminaires No.of Cell:Snsp.(Paddle)Fans Trani Total r, eformers KVA No.of Luminalre Outlets No.of Hot Tubs Generators KVA ta vt No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grud. 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 d Initiating Devices 11, No.of Ranges No.oe Air Cond. Total No.of Alerting Devices No.of Waste Disposers 'Heat Pump Number Tons IK_W No.of Self-Contained Totals: ......._____..__....._.._.._..._.._... ` "' Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑Municipal ❑ , _ Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: o,of Devices or Equivalent (� Heaters Signs Ballasts N No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent (A OTHER: /- �� Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value o I trical Work: ea-.6. °- (When required by municipal policy.) ,;,,,,, Work to Start: �- Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C 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 coverage is in force,and has exhibited proof of sane to the permit issuing office. CHECK ONE: INSURANCE 0 BOND❑ OTHER 0 (Specify:) I certify,under the pains an nahies o\...4.) r the!the information on is application is true and cotrtplde i('n�� FIRM NAME: - vcti„�j �P�.�� !./d J LIC,NO.: Licensee: --_.l.( ., 1 signature LIC.NO ./C- /9r (If applicable, 'exempt"in the license num ��-,(� Address: �X (c") �1� Bus.Tel.No: Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lie.No. CV y 7a Z �SC( OWNER'S INSURANCE WAIVER: I ant 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. 1 PERMIT FEE:$ I