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Home My WebLink AboutBlde-19-005174 ' Commonwealth of Official Use Only Permit No. BLDE-19-005174 ''•i,itt), Massachusetts 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:3/14/2019 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 belq .. q Location(Street&Number) 65 SIERRA WAY ��++++++1 Owner or Tenant DEMETRIADES GEORGIA Telephone No. Owner's Address DEMETRIADES NICHOLAS,2 BONNIE BRIAR, CROMWELL, CT 06416 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. _ j 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 kitchen, bath,&living room. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 12 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- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 12 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 8 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges 1 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 1 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Adam G Lepire Licensee: Adam G Lepire Signature LIC.NO.: 21742 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:8 PICASSO PL, OSTERVILLE MA 026551245 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 Ei3 Ce t ce- qftteiVg5 t,v adar2i eivxJ L#1((j19 15°—14 8 C'e4XF-49t L/43 jr Y —1,✓ 0 41(1 Olt 7/I 1 to fg --�_ Consmontesa h of Maddo Letts ,- • Official Use Only - 4 ,.__ '_ 2cpart,�� s (`� `�`5 l 17q �i= Permit No. - Occupancy and Fee Checked -r. BOARD OF ARE 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),52 CMR I .DO . ...4P-LEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2/ )3 /7 ,' - ,, City or Town of: YARMOUTH To the Inspector of Wires: E 't s application the lrndersigned gives notice of his or her intention to perform the electrical work described below. --; t s l�o 'on(Street&Number) SJ .c) — r or Tenant Telephone No. tnhr's Address "� I thhs permit in conjunction with a building '►i• ] permit. Yes V No ❑ (Check Appropriate Box) p!trpose of Building 7,)6tik,ek...t/V,617 Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd gr ❑ No,of Meters — New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: `rP---I/E- mpletion of theollowing�1 ay be waived by the Inspector of Wires. No.of Recessed Luminaires j Z No.of Cei -Snap.(Paddle)Fans f No.of Tots! 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 / z, No.of Oil Burners FIRE ALARMS jNo.of Zones No.of Switches g No.of Gas Burners No.of Detection and Initiating_Devices No.of Ranges / No.of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump Number 'Tons I KW No,of Self-Contained Totals: I f Detection/A(ertin Devices No.of Dishwashers / Space/Area Heating KW' Local❑ Municipal ❑ Other , Connection No.of Dryers Heating Appliances IOW Security Systems:* No.of Water No.of Devices or Equivalent No.of Heaters KW Signs No. Data Wiring: _ 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 desires or as required by the Inspector of Wires. Estimated Value of El ctrical Work. A?,, (When required by municipal policy.) O Work to Start: Inspections to be requested in accordance with MEC Rule l0,and upon completion. INSURANCE CO : 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 3 undersigned certifies that such cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE (BOND ❑ OTHER ❑ (Specify:) I certify, under the pai nd penalties of rjury,that the in rtnation on this application is true and complete. (4) FIRM NAME: J — •4/ Licensee: Signature (Ifappkcabl ,enter"exempt"in t e icense number line.) g LIC.NO.: Address /, / if7l �J•�,'_�,Z,��C'�L,t.-J144 0:2 ,��$us.Tel.No.: J "`Per M.G.L. c. 147, s.57-61,securitywork requires "ic S b�� Alt.Lic. No.: , 0�� Department of Public Safety"S"License: Lic.No. ` �z OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coveragerage n — many S required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. k Owner/Agent Signature Telephone No. 1 PERMIT FEE: $ ?6 I