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HomeMy WebLinkAboutBLDE-22-002311 Commonwealth of Official Use Only E_ Massachusetts Permit No. BLDE-22-002311 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:10/22/2021 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 electrical work described below. Location(Street&Number) 22 COPPER BROOK RD Owner or Tenant TARVER CLAYTON C Telephone No. Owner's Address TARVER JUDY CONNORS,22 COPPER BROOK RD,SOUTH YARMOUTH, MA 02664-4331 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: Bed&bath addition Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 3 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 1 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 10 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 8 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices 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 ❑ Municipal ❑ 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 Euuivalent 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: 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 •CQ-)uati11 (2.3f2,r RECEIVED r ' 202 nwaa&h e///taaaac e Official Use Only _ i OCT 1 2021 ,�,{- Permit No. 6� a,. �ol,}irs�swicse �4i I N G DEPARTMENT Occupancy and Fee Checked �' t' '-':-T•--- : 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 TYP41LL INFORMATION) Date: 1c2/2-f/2a2-r City or Town of: reu-1 zait-/j To the Inspec or of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Com/ -/ 6rap - i& .,,j� , 4 Owner or Tenant .,.....1 4,604 aj (/Gy 1J / t"r Telephone No. 1 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 11a9 Amps '(?Q/Z/OVolts Overhead© Undgrd 0 No.of Meters 4' New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters 1 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (2)ed ccyld 6/3/21Oslcit ( rte( Hoviity UXA// Ail Hai/- .,1 Completion of the following table may be waived by the inspector of Wires. TT No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA V. No.of Luminaire Outlets ,f No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting 4 'No.of Luminaires / Swimming Pool grnd. 0 grnd ❑ Battery Units --1 No.of Receptacle Outlets ,(Q No.of Oil Burners FIRE ALARMS 1No.of Zones ,- 'No.of Detection and No.of Switches g No.of Gas Burners Initiating Devices lH No.of Air Cond. Tons No.of Alerting Devices No.of Ranges Tons Heat Pump'Number'Tons 1KW No.of Self-Contained No.of Waste Disposers Totals: "' Detection/Alerting Devices MunIcipai No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other HeatingAppliancesSecurity Systems:* No.of Dryers KW No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Telecommunications%rin No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: /5o,1 Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 19.-00 (When required by municipal policy.) Work to Start: 4212 /`�� ' 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 cov rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 51 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of pedury,that the information on this application is true and complete. FIRM NAME: Li Z le-,c?-1r).cat rV i ce-s _ LIC.NO.: �Js LIC.NO.: 5�(elf2 Licensee: �7,,,M. !'1 1` Signature (If applicable,enter"exempt"in the license number lin .) Bus.Tel No.. Address: (2,0 662X ,(Z1 r VII g t *L. J-(610 AIL Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of PublZ6' O ic 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.