HomeMy WebLinkAboutBLDE-18-002197 Commonwealth of Official Use Only
E`_a Massachusetts Permit No. BLDE-18-002197
�,,�' 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:10/13/2017
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) 148 RUN POND RD
Owner or Tenant VARETIMOS LAMBRINI TR Telephone No.
Owner's Address R P R REALTY TRUST,4 JANNOR WAY,WEST YARMOUTH, MA 02673
Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box)
Purpose of Building - Utility Authorization No.
Existing Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters
New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Remodel livingroom
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 10 No.of Ceil:Susp.(Paddle)Fans No.of Total
Transformer KVA
No.of Luminaire Outlets No.of Hot Tubs Generato��^ KVA
No.of Luminaires Swimming Pool Above ❑ In- 0 No.of
L�/ OJ
grnd. grnd. RattervIy1 s
No.of Receptacle Outlets 12 No.of Oil Burners - FIRE ALA' get
No.of Switches 5 No.of Gas Burners No.of Detection li> "(///OA
Initiating Devices V O V '1
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 D
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ O
Connection
No.of Dryers Heating Appliances KW Security Systems:' 1 Ve
No,of Devices or Equivalent /Y'
No.of Water KW No.of • No.of Data Wiring:
Heaters Signs Ballasts No,of Devices or Equivalent
No.Ilydromassage Bathtubs No.of Motors Total IIP Telecommunications Wiring:
No.of Devices or Equivalent
OTIIER:
Attach additional detail f desired,oras 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 ❑ BOND ❑ OTHER 0 (Specify:)
1 certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Jarlath A Galvin
Licensee: Jarlath A Galvin Signature LIC.NO.: 10861
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:100 ACORN DR,OSTERVILLE MA 026551370 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:$75.00
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BOARD OF FIRE PREVENTION REGULATIONS
. 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 ININI;OR 7YPEALL INFORhM4770N) Date: LR. 't}
City or Town of: YARMOUTH To the Inspector of Wires:
. By this application the pndersigned gives pike of itisor her;Marton to perform the electical work described below.
Location (Street&Tcumber) 1 t V a, eL
Owner or Tenant k4 tRict ` �q's" Telephone No.ell ii slog
Owner's Address en Greetua SI ka C Tl
_ D Is this permit in conj'un'ction with a balding permit? Yes L No ❑ (Check Appropriate Boz)
nu t r_ I . Purpose of Building t ant.
t 11 r- 7�EN I Utlity Author nation No. —
N i'r Ji Existing Service ZOO Amps ysb / DO. Volts Overhead L—✓�J
Undgrd❑ No.of Meters
C\
i New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
4,a Y
F— I. Number of Feeders and 4mpscity --
Oll Location and Nature of Proposed Electrical Work:(�Me 't IGoe..%.
Completion tithe follow re table may be weived by the/r peel a of Tram
•
No,of Recessed Luminaires t p INo,of Cei-Susp.(Paddle)Fans No,of Total
(Transformers INA
No.of Luminaire Ousel INo.of Hot Tubs ICr�erators • LOVA
No.of Luminaires ISwi:oming Pool '°'bord. ernd.e 0 In- 0 INo.orBartervfLmranu
ergency r ng —
3mairs
No. of Receptacle Outlets . . 6I No.of Oil Burners Inn ALARMS INo.of Zones
No. of Switches 5, No,of Gas BurnersNo.of Detection and
Initiating.Devices
No.of
Fta"aets INo.of Air Cond. Ton' No.of Alerting Devices
Na.of Waste Disposers Heat Pump (Number Tons KW No,of Self Contained '
Totals:I Deteetion/Aleriine Devices
No.of Dishwashers Space/Area Heating KW' Isar Mtnxidpa!
❑ Connection 0 Otho
No.of Dryers (Heating Appliances KW Security Systems:*
No. of Water KW INo,of No.of .Data°W°• Devices or Equivalent
rinHeaters Sins Ballasts No.of Devices or Equivalent
No. Hydromassage Bathtubs INo.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 Sob (When required by municipal policy)
Work to Start Owl 10 f' ons 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 0 OTHER 0 (Specify)
I certify, under tights and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: At/aM VMt.o I N LIC.NO.:
Licensee: Z.-Anton ft Cpswgp Signature AA crit i+ LIC.NO.:_
(1f applicable,enter" onor*ranalicerere A�++obc!' ) Bus.TeL No..� 4p
. Address. I00 10110
it LiaL rliV Nth 164T A(t Tel.No.:
., "Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
- OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally Owen ed by law.
a. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owners agent
Signature Telephone No. I PERMIT FEE:S 1