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Home My WebLink AboutBlde-22-004654 Commonwealth of Official Use Only E0Massachusetts Permit No. BLDE-22-004654 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:2/23/2022 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) 33&35 BUTLER AVE Owner or Tenant Hello Costa Telephone No. Owner's Address WEST YARMOUTH, MA 02673 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: Repair&re-attach exterior SEU cable 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 ❑ 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 Signs No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: Rex A Burger Licensee: Rex A Burger Signature LIC.NO.: 17037 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:2045 MAIN ST, MARSTONS MLS MA 026481864 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:$50.00 PA Ift4S Erill&C.i9 sfgst:iL 2/241/-22Z eg— ?-4..: K 14 CommoaweaRh o/riliSIMACIUteitth Official�Use Onlly�/ (� ..tip x! 2spartn�snt el..trno Services Permit No. L'�1(� - 0,, _ f — -' Occupancy and Fee Checked 1 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed ht accordance with the Massachusetts Electrical Code(ME ,527 CMR 12.00 Is (PLEASE PRINT IN INK OR TYPE , INFOR TION) Date: � �� City or Town of: yLc da ri To the Inspector of Wires: r, By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 3 3 eviler- AYe Owner or Tenant Hell e COS iC- Telephone No. c k) Owner's Address o�9(offs ' - ata()W- Is this permit in conjunction wi. 'building permit? Yes 0 No ® (Check Appropriate Box) �. Purpose of Building fe_esi i7 a ( Utility Authorization No. k , Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters ` Number of Feeders and Ampacity L, / Location and Nature of Proposed Electrical Work: f�Mee..l1 ,j e_r✓t c e A oc./S 2 Completion of the followinglable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ce L-Soap.(Paddle)Fans Transformers TICVA - No.of Luminaire Outlets No.of Hot Tubs Generators KVA A No.of Luminaires Swimming Pool Above ❑ In- ❑ Na of Emergency Lighting tu'nd. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners Na of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total ons No.of Alerting Devices No.of Waste ra Heat Pump Number:Tons KW -No.of Self-Contained - Totals: Detection/AlertinngDevices ,No of Dishwashers •Space/Area Heating KW Lead Mnection 0 Other No.of Dryers Heating Appliances KW SecuNa o System nf Devlcos*or Equivalent No.of Water , No.of No.of Data W g: Heaters Signs Ballasts No.of Devices or Equivalent unications No.Hydromassage Bathtubs No.of Motors Total HP Tel N ofDevices origEent OTHER: Attach additional detail if desire4 or as required by the Inspector of Wires. Estimated Value of Electrical Work: S 00'OD (When required by municipal policy.) Work to Start: ).,Ja//do 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 0 BOND 0 OTHER 0 (Specify:) I ceiriJ,,under the pains and penalties of ry that the formation on this application is true and complete: FIRM NAME: A ,t/f' id,c LIC.NO.: Licensee: I&)C Signature LIC.NO.: 9417 03-7 (If applicably,enter"exempt"i the license number line.) Bus.Tel.No.: Address: 1 d i(/`1 ujcf.:� i41,,,,i,j,,C 4 i/y 44 4- r,3 G r q' 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)❑owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$