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Home My WebLink AboutBLDE-22-002480 *`I of `'1V\, ,.r' Commonwealth of Official Use Only f Permit No. BLDE-22-002480 € ..� Massachusetts CARD 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:10/30/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perfo th electrincaTl work des� ib below. Location(Street&Number) 19 BENNETT AVE n I2.C1� UG Owner or Tenant Olieefgald=bigaiLYITA Telephone No. Owner's Address :. _ ---- •-- - -' - 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 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd CI No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel bathroom. 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 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 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 Ballasts Data Wiring: Heaters Siens 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: Licensee: Lazar Mitev Signature LIC.NO.: 56442 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 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:$75.00 (< 7,i q..4 e._.(_(C ` 0S4-M L)1V) qL14441- a (4-2 {rTh CA 7 (7 g4 Commonwsa!#01 maaeachu4s1:10 Official Use Onl l'- -. �i c�r� cc''�� Permit No. (2 2Z �&o �` 2 spartmsnt of..tire Seruicsd --, I; -:* Occupancy and Fee Checked .. ` ' BOARD OF FIRE 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),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: .1 C7/2*2 ( A City or Town of: 4Ii64 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) 1.5 baupre- / / i ov r�tf-pte Owner or Tenant tie/1 `'"U.s Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes es No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service/ 7 Amps •ai,/ 2ie Volts Overhead[3 Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd Cl No.of Meters Number of Feeders and Ampacity // Location and Nature of Proposed Electrical Work: ,rt�G1 ge zie/ ,?',,. Completion of the followingtable may be waived by the Inspector of Wires. No.of otal .1' No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grad. ❑ grnd. ❑ Battery Units -_- No.of Receptacle Outlets 4 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2_ No.of Gas Burners No.of Detection and Initiating Devices Tot I' No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers H�Totalst p Number Tons ' No. Devices No.of Dishwashers Space/Area Heating KW Local❑ Connection Municipal ❑ Other No.of DryersHeating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of KW 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: le Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RXGE: 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 ❑ OTHER 0 (Specify:) I certify,under theL42 ins and penalties of perjury,that the information on this application is true and complete. FIRM NAME: - ,''/&�-frj(l Seri ee LIC.NO.: Licensee: LA- L tMl/t Signature — LIC.LIC.NO.: , /1Z (If applicable,enter"exempt"in the I'censeTimber line.), Bus.Tel.No.• Address: Pc) 6 X i')/ft to. 122,4045 ;i r-iAl r 626/' Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Deptfrinent 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 required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.