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Home My WebLink AboutBLDE-22-004742 C• •11 Commonwealth of Official Use Only 4.11,6) d.0 ��' Massachusetts Permit No. BLDE-22-004742 �9 :ri AR II 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:2/25/2022 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. G, Location(Street&Number) 15 PAULA LN '7®I —S' -S741 Owner or Tenant SOLIMINI NICHOLAS A Telephone No. Owner's Address 15 PAULA LN,WEST YARMOUTH, MA 02673 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: Remodel living room, dining room, &sun room. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 10 No.of Ceil.-Susp.(Paddle)Fans 1 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 6 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6 No.of Gas Burners No.of Detection and Initiatine 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 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: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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: $75.00 ?,L( (ZY c3Etr(A-AL t_nvtr) 10 1311-2)" leE-- t ( ( 7/ g4Con�monw•akh o`11/aeeachiaeetie Official Use+Only 4, -.Y'•~ • Grrenl e/on n(� Pctmit No. ` t'm,^'- Par Jiee Jewicee If— 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: a —o) —, o).2 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives no'e of hi or her intention to perform the electrical work described below. Location(Street&Number) /,f ,h /✓/� G/y�J� Owner or Tenant //G/ld/,qs 4. ,S0 7 r' / d?d `V(,qrC /��"r N/ Telephone No. 7 P/'fd G j 77 Owner's Address .S`- /i4 Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building /71Q I4-7 Uttlity Authorization No. Existing Service /eV Amps //° / d 41 Volts Overhead Undgrd B ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd Number of Feeders and Ampacity g El No.of Meters Location and Nature of Proposed Electrical Work: X�yl,�r r L L/,..,- JN �i�✓i/1/f/SLr//f.raps r iv 4° Completion of the followin table mar be waived by the In vector of Wires. U, No.of Recessed Luminaires a No.of Cell.-Snap.(Paddle)Fans 0'of Total TransformersKVA U �; No.of Luminaire Outlets No.of Hot Tubs Generators KVA A No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting Qrnd, trod. Battery Units C) `' No.of Receptacle Outlets (p No.of OB Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners O No.of Detection and 1`' No.of Ranges Total Initiating Devices g No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Reat Pomp limber Tons 1 KW 'No.of Self-Contained O Totals:I I_''-"""1-"..---- Detection/Alerting Devices No.of DishwashersSpacefArea Heating KW 0 Local Municipal No.of Dryers a Cyonnection 0 Other No.of Water Heating Appliances KW 0 Security Devices or Equivalent Heaters KW�r knot Data Wiring: Si ns Totalasts No.of Devices or E uivalent No.Hydromassage Bathtubs p No.of Motors HP a ecommun ca ors r g OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: Do'D,p D Attach additional detail if desired,or as required by the Inspector of Wires, Estimated to Start:Va /o/' fi / (When required by municipal policy) �L 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 0 BOND 0 OTHER cify:) I certify,under the pains and penalties ofperfury,that the information on this application is true and complete FIRM NAME: Licensee: LIC.NO,: Licensee:e,enter"esempt"in the licence number line.) Signature LIl, NO.: Address: Bus.Tel.No.`�— Per M.G.L.c.147,s.57-61,security work requires Department of Public SafetyS"License: Alt.TeL No.:___�_ OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insumncc coverage normally Lic.No. required byg law. By my s' nNreyeto hereby waive this requirement. I am the(check one m owner ■owner's a:ent. Signature Telephone No. ci'"/—S,lG f)._