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Home My WebLink AboutBLDE-22-004903 ^� Commonwealth of Official Use Only V`" L V` Massachusetts Permit No. BLDE-22-004903 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:3/7/2022 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) 68 HORSE POND RD Owner or Tenant KANTROWITZ WILLIAM A Telephone No. Owner's Address 1766 BAY DRIVE, POMPANO BEACH, FL 33062 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: Relocate panel.Wiring in ceiling. 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. grad. 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 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: Simon Baba Signature LIC.NO.: 22714 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:29 Captain Lumbert Lane,Centerville Ma 02632 Alt.Tel.No.: 7749949255 *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 (x4w1 RFCEIVED sMAR 0 .. -4, , Voonwea oi it/aeeacatteelfe Ot}icial Use only t +�:i� Uepartma�oit gips Jnervuee Permit No. o 41- BUILD! JC. 4T Fsy ---------_-- - Occupancy and Fee Checked .!!` OARD OF FIRE PREVENTION REGULATIONS � , 1/07j APPLICATION FOR PERMIT TO PERFORM ELECTRIC i All work to be performed in accordance with the Massachusetts Electrical Code M A.0 WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMA77ON) •s2�CMR 12.00 City or Town of: YARMOUTH Date: -3 — y — Z Z To the Inspector of Wires: LDI y this application the undersigned gives notice of his or her intention to perforin the electrical work described below. ocation(Street&Number) , i L• w. '011a ,I , Owner or Tenant . , h4. . r w;1 1.' Owner's Address q/ lith . - Telephone No. Is this permit In conjunction with a building permit? Yes `', ug— 6�, � No 0 (Check Appropriate Box) purpose of Building_ ppro elate Utility Authorization No. zisting Service Amps / Vona Overhead❑ Undgrd 0 No.of Meters Amps / Volts Overhead 0 Undgrd — Number of Feeders and Ampacity ❑ No.of Meters Location and Nature of Proposed Electrical Work: ; o� .�� n /'•HC' ,: G k kit -;01111,_ lne 'I1:m�. .r tee,l' lb Na of Recessed Luminaires , 'tenon o the ol/owin: to, em, be waived b the I Na of CeIL `o.o for o Wires, st°, -. -Soap.(Paddle)Fans Transformers uta Na of Luminaire Outlets Na of Hot Tubs KVA 4 Na of LuminaireGenerators KVA Swlmmiag Pool 4,e n- 'o.o 'me en �' No.of Receptacle Outlets ❑ rid• ❑ Batte Units ng .,t, No.of OB Burners Ilia of SwitchesNo.of Zones No.of Gas Burners `a o ► eco 111111, II k.r Inidatin Devices No.of Air Cond. o Tons No.of Alerting Devices o.of Waste Dbposers 'eaT amp `um r W I `o.o P3On. n otals: No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW �„ Na of Dryers I'0el Connection 0 Other' .a o "a r Heating Appliances W K ; o.a No.of r evices or ' i Myeloid Neaten KW S _ s Bapaoata Data Wiring: Na H dromasaag No.of Devices or ' y e Bathtubs No.of Motors Total HP e ecommun a; ns f inert OTHER: Na of Devices or ' u ent Estimated Value of Electrical Work: ......54..5_ Attach additional detail?Masked,or as required by the Inspector of Wires. S dC (When required by municipal policy.) Work to Start:� �Z Inspections to be Unless wioed toby the queste o accordance with�Rule 10,and upon completion. the',licensee INSURANCECOVERAGE:proof of liability ., permit for the performance of electrical work may issue unless a e licensed providesiethat such oov insurance including completed operation"coverage or its substantial equivalent. The CHECK ONE: INSURANCE ge is in force,and has exhibited proof of same to the permit issuing office. I Hrdjy,ander the ,iris and BOND 0 OTHER 0 (Specify:) FIRM NAME: e In s n eiss re •,,,ies fpa�ary,that the Information on this op)rlicoffoa is true and complete. Licensee: i rv►s '�r t^_ LIC.NO.: I t1 (1censee: terSignature ►� Address: "ammo:"in the tke �ber line.) I LIC.NO.: s Z B tr►� A K t n/I A 3Z Bus.TeL No.• *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: BAIL.TeL No.: OWNERS INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage no Lic.No. required by law. By my signature below,I hereby waive this requirement. I am the(check one ■ owner ■ owner's l Signature Y Telephone No. a_crit. PERMIT FEE:s 2�'