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Home My WebLink AboutBlde-18-005854 (../ Commonwealth of Official Use Only fe' Permit No. BLDE-18-005854 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 INFORM4TION) Date:4/23/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 48&50 IVANHOE AVE Owner or Tenant TSOUKALAS GEORGE Telephone No. Owner's Address TSOUKALAS JAMES, 20 BAYBERRY RD,ACTON, MA 01710 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appr • te Box) Purpose of Building Utility Authorization No. O Existing Service Amps Volts Overhead 0 Undgrd 0 .of N& > -.. . New Service Amps Volts Overhead 0 Undgrd 0 . tetcj's4E' • Numbr F Nature and ty 40' I 47 Location and Nature of Proposed Electrical Work: Wiring for bathroom exhaust fan. Completion ofthe followingtable maybe wa�U 4* • cctWires. _ p gt/nJ No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Transformers No.of Luminaire Outlets No.of Hot Tubs Generators • a 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 No.of Detection and Initiatine 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/Alertine 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 Siens 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: Charles L Salemis Licensee: Charles L Salemis Signature LIC.NO.: 33561 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 534,WATERTOWN MA 024710534 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 , TA- )( 1.,/ 4 8/C---y- 3,,-; %-\js\\)-IV fomn-..orwcaLl"h. of ¢+6secl-44 ccE - Official Use Only cam, n - '°.+e 4 1JcPcrF..,nrr .1 Jet o� rvicea Pern2 t No. BOARD OFFIRE PREVENTION REGULATIONS Occupancy and Fee Checked et Rev. 1/07] (leave blank) APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accui Dance with the Massachusetts Electrical Code(:M.EC),527 C1AP.1 ZDO (PLEASE_PRINT1N K OR fl?E ALL INFOR11.LTION) Date: City or Town of: YARVIOL-'I'H To the Inspector of Wires: . By this appbcabon the undersipied -ves notice of his or her intention to perform the electrical work described below. Location (Street&Number) Owner or Tenant 'l— /cS cYJ%Q C,../{-c' Telephone No. Owner's Addre � ,-7Z�-00/ /��e �� J 1C,` — Is this permit in con) with a building permit? Yes No (Check Appropriate Bar) Purpose of Building- /4,15-4JC—e5 Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd No. of Meters New Service amps / Volts Overhead^ Undgrd No. of Meters Number of Feeders and Arnpacity Location and Nature of Proposed Electrical Worm: i j" ! �3 �� _ _ _ . Completion of the ollowaz?f table may be wved by the Inspector of Tins No. of Recessed LuminairesNo. of Cal-Susp.(Paddle)Fans No.°1 Tots! Transformers KVA No. of Lumina ire.Outieu No.'of Hot Tubs Generators ii'VA No, of Luminaires s _— minePool i'mrnov e ❑ inr-nd. ❑ Bathe rmrs,ry ,g No. of Receptacle Outlet No. of Oil Burnerrs 1FTkE ALARMS No. of Zones No. of Switches No. of Gas Burners No.of Detection and I.nia-thin Devices No. of Ranges Na of Air Cond Total Tons INo,of Alerting Devices Heat Pump Dumber ITons I KW {No. of Self-Contained Totals: I I lDemcnon/Alert ino Devi No.of Waste Disposers ces No. of Dishwashers Space/Area Heating KW' Local Q Mua4cipal Connection 0 Other No.of Dryers Heating Appliances , Security Systems:* No. of Water No.of Devices or Equivalent Wiring: No. of Heaters KW Na. of Data Sins Ballasts No.of Devices or I;quiv'alent s I No. Hydromassage Bathtubs No. of Motors Total HP Telecomm¢nications Wtrm — OTARR / No.of Devices or Equivalent • ' Attach addit ional detail f desired or as required by the Inspector of-Wirer. Estimated Value of Electrical Work`f�./ / r (When required by municipal policy.) Celt Work to Start: vpv 45/Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE VE GE: Unless waived by the owner,no permit for the performance of electrical work mayissue the licensee provides proof of liability insurance incluriin "completed operation" equ unless undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing oifiCe. cut The CHECK ONE: INSURANCE Z BOND ❑ OTHER ❑ (Specify:) I certify, render th aims and penalr;es of p er FIRM NAM I n , tit information on this application is free and complete �1•;� -� ��cY�45 v/fG C N-5zi.4, S LI Licensett;� 6l6' n\ Signature LIC.NO.: V (If applicoblenter C pt"in the license number line.) Address: ? M Bus.TeL No j 'Per MG.L. c. 147, s.57-61,— security work requires Department of Public SafetyAlt Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nor have the liability insurance coverag�y required by law. By my signature below,I hereby waive this requirement 1 am the check one owner Owner/Agent01 )❑ ❑owner's anent Signature Telephone No. PERMIT FEE: $