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Home My WebLink AboutBlde-21-005111 o• Commonwealth of Official Use Only �Ei Massachusetts Permit No. BLDE-21-005111 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.I/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:3/10/2021 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 electncal work described below. ej n �� Location(Street&Number) 135 SOUTH SHORE DR UNIT E J Owner or Tenant MOORE THOMAS Telephone No. Owner's Address 6 LANTHORNE RD, MONROE, CT 06468-1728 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 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel kitchen&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 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. 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 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 ❑ BOND CI OTHER 0 (Specify:) e7 7,f 2( 2— �P 3—1 Q 3 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 signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature /2kctc� Telephone No. PERMIT FEE: $75.00 art) " Nit Tb i17e AV- Split& , Lit f� z/� - ^ � COMM01114/114A 01 Ma&SaCIU&14116 Official Use Only • l 2-._ —S� <( '- t Permit No. i� .„, ,; sParfmsnl o/gips�swicsd i. i m :' BOARD OF FIRE PREVENTION REGULATIONS Rev.1/0cy and Fee Checked ''' � ) (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 INFO MATION) Date: �,jib / Z y City or Town of: V/Ne2 To the Inspector of tress By this application the undersigned gives notice of is or her intention to perform the electrical work described below. Location(Street&Number) /l35 -.'i & ( \.,.)tJ t v -c, J Owner or Tenant (0i eiie aid I at Ve- f'(a rA-144 Telephone No. ,fib, '-yo .—e75 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No 2 (Check Appropriate Box) Purpose of Building iiva t 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 Ampacity t Location and Nature of Proposed Electrical Work: / d x l50/h7 c=2'i2el it ; LID ells he ' ed vi Completion of the followinktable may be waived by the Inspector of Wires. No. Total ran KVA No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA TE No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting _grnd. ❑ grnd. ❑ Battery Units '-2 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 ota r No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 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 0 Municipal ❑ Connection thher No.of Dryers Heating Appliances KW Security y 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: 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: INSURANCE ❑ BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. Ti411 5 FIRM NAME: 1.4 2 ,/eIr./K. / cl'/ 7c Utr- LIC.NO.: Licensee: /72,,://7 /t/'tat/ Signature LIC.NO.: ,�� 6 (If applicable,en er"exempt"in the license number line.) Bus.Tel.No.: �ti C? i=�3 Address: 1 ,0 b/pc 12 /9 i 1,0,1221H, S /ibt'/7/o2G72 Alt.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 required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.