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Home My WebLink AboutBLDE-19-001510 -i .�,a� Commonwealth of Official Use Only ft* Massachusetts Pernik No. BLDE-19-001510 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.l/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:9/13/2018 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. �„l,''�(4�� M Location(Street&Number) 39 CHANNEL POINT DR Fa, Owner or Tenant KENEFICK JOAN E TR Telephone No. ,., 1 Owner's Address C/O THE STORAGE SHED;ATTN:FRANK,275 BAILEY ST,CANTON,MA 02021 S 4'jV Is this permit in conjunction with a building permit? Yes CI No ❑ (Check Appro nate Box) �j7 Q Purpose of Building Utility Authorization No. LTi% '33 -o Existing Service Amps Volts Overhead 0 Undgrd 0 .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: Replace meter socket. , 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 0 In• o No.of Emergency Lighting Rrnd. 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 0 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 Data Wiring: Heaters Signs Ballasts 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Julius Prizgintas Licensee: Julius Prizgintas Signature Lie.NO.: 20442 (If applicable,enter"exempt'in the license number line.) Bus.Tel.No.: Address:97 CHUCKLES WAY,MARSTONS MLS MA 026481583 Mt.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 signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature ��r Telephone No. PERMIT FEE:$50.00 YY`_moic1 9(r7/l0 C - , , 4 Comma. S4 nava&o/Nakao ff! fficial Use Only r, . \S = ni� cc�� cc77 Serviced Permit No. ( cirjs La 1JrParimrr�o�yin Jiroius .. '1. Occupancy and Fee Checked \''' BOARD OF FIRE PREVENTION REGULATIONS ev. 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: •p/22//or 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) 3 0 '(gg^/yc L :DO//t/ r Owner or Tenant C41/22S/ tfA,,c f/C- Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No.4gt— (Check Appropriate Box) Purpose of Building /Net//NG' Utility Authorization No. ja Existing Service owe Amps /10 / c'(OVolts Overhead 0 Undgrda` No.of Meters Q ! -, New Service 20 Amps 120 /j QOVoits Overhead 0 Undgrd? No.of Meters 4# 9 Number of Feeders and Ampacity L..,.elon and Nature of Proposed Electrical Work: ,('Fo//9C( fig Te- ee .S0reCr7 0 r- z W "...car_ 7 i Completion of the follawingtable may be waived by the Inspector of Wires. L. if Recessed Luminaires No.of CeiL Snsp.(Paddle)Fans No.of Total Transformers KVA W e` in 0. if Luminaire Outlets No.of Hot Tubs Generators KVA V .0\1 W 6o. A Luminaires Swimming Pool Above 0 In- 0 No.of Emergency Lighting Cr) t;rnd. ornd. Battery Units W {to.,rf Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones re No'if Switches No.of Gas Burners No.of Detection and ' Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump f Number}Tons KW No.of Self-Contained Totals:1 — I —" Detection/AlertintDevices No.of Dishwashers Space/Area HeatingKW' Municipal p Local0 Connection 0 other No.of Dryers Heating Appliances KV, Security Systems:" — No.of Water No.of Devices or Equivalent Z Heaters KW No.of No.of Data Wiring: 0 Signs Ballasts No.of Devices or Equivalent V No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail Or desired oras required by the Inspector of Wires. IS Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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 ay 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. eV CHECK ONE: INSURANCEBOND 0 OTHER 0 (Specify:) I certify,under the pains and pjZies of perjury,that the information on this application is true and complete. () FIRM NAME: .S'//UJ Aa/2 C_/.4/y/9-s LIC.NO.• �/�O0G4Q_�Z V Licensee: / /�i SignatureLIC.NO._'O �i__� (Ijapplitabl ter"exempt"in the lice, number- line.) Bus.Tel.No.. S0� �� /g ' n Address: Tel.No.: Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: A14 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 t Owner/Agent j j Signature• Telephone No. I PERMIT FEE: $ �p