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Home My WebLink AboutBLDE-19-2051 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-002051 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked VRev.l/071 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:10/5/2018 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. Location(Street&Number) 657 ROUTE 28 Owner or Tenant MITROKOSTAS NAFSIKA E TR Telephone No. Owner's Address S&N REALTY TRUST,PO BOX 260,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 ❑ 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: Replacement furnace(UNIT A-3 DENTIST OFFICE) 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 No.of Waste Disposers Heat Pump Number I Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Cl 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 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 LIC.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 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:$80.00 gtcP 10/3t(/8 f_ � &_ 4fashanda official Use Only a cc�� cc77� pp Permit No. ` ' Sat €gr .[ partnwnt o`Jins Jenda! tut Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) (less 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: /O—Z— / City or Town of: `y/iM-nfl /t To the Inspector of Wires: By this application the undersign fl gives notice of his or her intention to perform the electrical work described below. . .tatri,� Location(Street&Number)/ -5 7 /17444 Si W. l///dlL,41u/1, ✓ttll i A-3 o6rcC Owner or Tenant .5-I-id RC/3LTy Telephone No. Owner's Address Riari C Is this permit in conjunction with a building permit? Yes 0 No Q- (Check Appropriate Box) Purpose of Building Q/l4a c tet 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: Zi...e , .. v/L7 q pads- ...,7 en rro ..rb-C,E Completion of the foil, •; • table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cert-Susp.(Paddle)Fans Nan Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Na of Luminaires S Pool Above Io- No.of Emergency Lighting ' m1ng end. u gni& ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones Na of Switches Na of Gas Burners a of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons No.ofAlertingDevices Toes Na of Waste Disposers Heat Pump Number Tons KW o.of Self-Contained Totals: L Detection/AlertintDevices No.of Dishwashers Space/Area Heating KW Loral 0 MunnenicipalMion 0 Otho, Co No.of Dryers Heating Appliances MY SecuritySystems:• Na of Devices or Equivalent No.of Water KWNo.of No.of Data Wigg Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelNommaniationsWiringg.� Na of Devices or Equivalent OTHER: Attach additional detail ifdesireel or as required by thelnspeetor of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start:/O"Zr/1 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 covers in force,and has exhibited proof of same to the permit issuing office CHECK ONE: INSURANCE aTBONND 0 OTHER 0 (specify:) &"1"Int -17-1-C g'7i y I certify,under tir�ee circ and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: ,SILVP Cr/G ,G.IC- LIC.NO.:49 / t/ 7 Licensee: Ca seek IA) SUS. a— Signature LIG NO: ../6 C( (Ifapplicable enter exempt"friths license number line) Bas.Tel.No.- ?8-q 2Ft--4O II L Address: "6O i3ctJez.,3£. Day RD S4N£a4 gal M 4 a ZSC At TeL Na:Co 1-114-.44-9.1 1( °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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT;FEE:S