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r '. Commonwealth of Official Use Only
I`• '�� Massachusetts Permit No. BLDE-18-006864
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:6/4/2018
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) 125 CAPT SMALL RD
Owner or Tenant BISBAS DROSOS Telephone No.
Owner's Address BISBAS MELANE, 180 PARKER RD, NEEDHAM, MA 02494
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ap, 'i` t ox)
Purpose of Building Utility Authorization No. /
Existing Service Amps Volts Overhead 0 Undgrd 0 1 of
New Service Amps Volts Overhead 0 Undgrd 0 40 i, •tk /y
Number of Feeders and Ampacity ,
Location and Nature of Proposed Electrical Work: Wiring for new condenser&replace panel. Q
Completion of the following table may be waiv or of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of a
Transformers
No.of Luminaire Outlets No.of Hot Tubs Generators "A
No.of Luminaires Swimming Pool Above 0 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 No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. 1 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 ❑ 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: DANIEL J PECKHAM
Licensee: Daniel J Peckham Signature LIC.NO.: 26830
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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:$50.00
7C-2. 11:1A.12etk•-)C, / )s) ‘'(tt(I S t
omn+oruo of///assaciswsf� vial Use Onl
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c7 Permit No.
\� _ = lal Apartment o
• Occupancy and Fee Checked
tt --,::,—..:/- BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/07] . (leave blank)
APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code 7 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMAT1019 Date: , ti
City or Town of: YARMOUTH To the Inspecto of Wires:
By this application the pndersigned gives notice of his or her intention to perform the electrical work described below.
i • Location (Street&Number) l AS' ?mac.,, .
Owner.or Tenant t3,s bG _ Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes No
❑ ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
-Zing Service Amps / Volts Overhead ❑. Undgrd gr ❑ No.of Meters
, .. ,z•N w Service
L Amps / Volts Overhead ElUndgrd El NO.of Meters
Ij T.:-.- .2'ulmber of Feeders and Ampacity
bon and Nature of Proposed Electrical Work: 4. Az/
l
� C� `�! 4h� ..i f
Completion of the following table may be waived by the Inspector of Wires.
i' 1Q of Recessed Luminaires No.of Cea7.-Sgyp,(paddle)Fans No.of Transformers KVA KVA
W No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grad. grad. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
tal
No.of Ranges No.of Air Cond. To No.of Alerting Devices ,
ns
No.of Waste Disposers Heat Pump Number(Tons I KW No.of Self-Contained
Totals: Detection/Alerting Devi
I ces
No.of Dishwashers Space/Area Heating KW Local El Connection
❑ Other
Connection
No.of Dryers Heating Appliances , Security Systems:*
` No.of Water No.of Devices or Equivalent
No.of No.of Data Wiring:
1 K`,�,Heaters Signs Ballasts
No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
I Attach additional detail if desired or as required by the Inspector of Wires.
t 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
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: INSURANCEBOND ❑ OTHER 0 (Specify:)
I certify, under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
' Licensee: i,i pc,_k. ri -�Signature / LIC.NO.: ?h i-,1 p I
(If applicable,enter"exempt"in the license number line.)
a
Bus.Tel.No.:
Address: ,ems 2 Ac it..�ys L-,z vizeat6 ...-s,,.„ L/s e3 2.4. 4"y Alt.Tel.No.:SoSi-Z Zb-�E t�3---
J *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
S required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner ❑owner's a eat.
Owner/Agent
iSignature Telephone No. ( PERMIT FEE: $ � I
;/oi'YRR TOWN OF YARMOUTH
;',:: o BUILDING DEPARTMENT
0., ,it y 1146 Route 28, South Yarmouth, MA 02664
'°� MATTA .� . 508-398-2231 ext. 1263 Fax 508-398-0836
K. Elliott, Inspector of Wires
kelliott(avarmouth.ma.us
June 11,2018
Daniel Peckham
87 Audrey's Lane
Marstons Mills,MA 02648-1629
RE: Drosos Bisbas, 125 Captain Small Road
Permit Number: BLDE-18-006864
Dear Dan;
The above noted location inspection failed to pass for the reason(s) listed.
Required ground rods & intersystem bonding
device to be installed.
Please forward the required re-inspection fee of eighty dollars ($80.00) to this office and
advise when the corrections have been made and when access may be gained,to the property,
for the re-inspection.
If you have any questions please do not hesitate to contact me.
Sincerely,
Town of Yarmouth,Building Department
K. Elliott,
Inspector of Wires