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Home My WebLink AboutBLDE-23-002636 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-002636 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:11/14/2022 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) 42 DEBS HILL RD UNIT 3A Owner or Tenant CAMPANE ROSEMARY ANN Telephone No. Owner's Address 42 DEBS HILL RD, YARMOUTH PORT, MA 02675 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement furnace. 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 1 No.of Detection and Initiating 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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: Joseph W Silva Licensee: Joseph W Silva Signature LTC.NO.: 9147 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 BOURNE HAY RD, SANDWICH MA 025632761 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 16—CZCS (L//( `-C(7)7i i1 ��jj '/7-/ Commonwealth o//I'lamach.uealfa Official Use Only (jI 1= i Permit No. �."� ��_� . ePar nt o ere ervicee - William g 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:/7 7—" ZZ City or Town of: \Ipt-ii-E„-✓'IF- 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) ii."0-- ()&5S 64-ELL A Owner or Tenant .L,c I=l�-`t c i eif,ti h Telephone No. '1 Owner's Address[v-D f)Ct/' c'`I coJS '1/L0-c,-. CA..:.a-fr-4- n,e-IX-7 AV 7-75 t 7 1 E Is this permit in conjunction with a building permit? Yes U No 0_,(Check Appropriate Box) Purpose of Building-Si "7/4- Utility Authorization No. AExisting Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters n J New Service Amps / Volts Overhead n Undgrd rl No.of Meters N Number of Feeders and Ampacity t� Location and Nature of Proposed Electrical Work: f i-L evv✓<i 1c,96:,ci m 7 Z4-5 tU.CA//1Le. Completion of the following table may be waived by the Inspector of Wires. S 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 �d ❑ grad. ❑ Batte Units - 1 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 1 No.of Air Cond. Total .No.of Alerting Devices No.of Ranges Tons No.of Waste Disposers Heat T Pump Number Tons KW ,No.of Self-Contained ,,Detection/Alerting Devices nicipal 1 No.of Dishwashers Space/Area Heating KW Local❑ Connection El Other Heaters Signs Heating Appliances KW Security Systems:* No.of Dryers No.of Devices or Equivalent No.of No.of Data Wiring:No.of Water 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: (When required by municipal policy.) Work to Start: L1'7-Z-Z- 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 El (Specify_) e0,-,-, ' C- -.1.--J-S li3/?"g, I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: S/LAMM F C i 2lc_. LIC.NO.:-? 417 Licensee: ---1 ESLf It vi .S% --J'`---- Signatur LIC.NO.:£Z/G i'7 (If applicable,enter "exempt"in the license number line. Bus.TeL No.:-6=,k``FZ->:` 4 F` Address:, O Beh - 14 -1 .o ,3•6'19<14c! /11 oZ-5'4 3 Alt.Tel.No.:6-0 3(-`t-`i3/ *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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 El owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. _