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Home My WebLink AboutBLDE-22-005247 Commonwealth of Official Use Only fi Massachusetts Permit No. BLDE-22-005247 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:3/21/2022 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) 8 PEARL ST Owner or Tenant NICKANDROS BESSIE TR Telephone No. Owner's Address BESSIE NICKANDROS REVOCABLE TRUST,8 PEARL ST,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: Replacement furnace. Completion of the following table may be waived by the Inspector of Wires. W No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Trapsformers KVA q No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Unitsi. No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices 60 No.of Waste Disposers Heat Pump I_Num4erTons KW No.of Self-Contained Totals: I 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 Eauivalent keI 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: Matthew Gordon Signature LIC.NO.: 55830 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:22 Station Avenue, South Yarmouth Ma 02664 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 ID owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 i(CC. . (29( z../ I �►DR.. ,1q-,i)5)(0 � . ECE VED �[yy� /� `7 r//aeeQc�iuel�e MAR 1 !-- � l.onunonweat Official Use Only c� cc77 ��aa I: �[lsioartinsnl o`-}l,.Jirwrese Permit No. _;77%5-247 BUILDING DE .� -� k� -'_._ , 5 pancy and Fee Checked It._ BOARD OF FIRE PREVENTION REGULATIONS [R, 1/07) APPLICATION FOR PERMIT TO PERFORM E (TVs blank All work to be performed in accordance with the Massachusetts Electrical Code(ECTRICA 527 CM 00 WORK YPLEASEPRINT IN INK OR TYPE ALL INFORMATION) 12 �� City or Town of: Date: YARMOUTH To the Inspector of Wires: L3y this application the undersigned ves notice iehisor her intention to perform the electrical work described below. ocation(Street&Number) •� r re e Owner or Tenant -a G - 9 \ Owner's Address Telephone No._5_0_,Cfze5(i3 61,, Is this permit in conjunction with a building permit? Yes 0 No purpose of Building_____________ 0 (Check Appropriate Box) Utility Authorization No. !listing Service Amps / Volta Overhead 0 Undgrd❑ No.of Meters _ /yew Service Amps / Volts Overhead Number of Feeders and Ampacity ❑ Undgrd❑ No.of Meters Location and Nature of Proposed Elech'kal Work: {• �Ir"G ( A e, 1----7::—.. C Com,letlon, the oil, ; table m, be waived lb Na of Recessed Luminaires Na of Cell.-Susp,(Paddle)Fans °.o the I o>tor o Wires. Na of Luminaire OutletsTransformers KVA Na of Hot Tubs Generators KVA 4' Na of Luminaires Swimming Pool �d.e 0 n- 0t 0e 'Unit, 7, ng ;;;,' No.of Receptacle Outlets 'd' ❑ Butte Unita n No.ofOil Barnes FIRE ALARMS No.of Zone, c Na of Switches No.of Gas Burners. '0.0 ^ec, D an 12.± lata of RangesInitiatin Devices No.of Air Cond. Toss No.of Na of Waste Disposers 'eat amp 'nm r oafs Alerting Devices Totals: .__ __. Detection/o on• D Na of Dishwashers Space/Area Heating KW Local❑ ..u'U °' Devices No.of Dryers Connection 0 Other Heating Appliances Key , w y . , °'° Her KW o,o o.o Na of Devices or nivalent Data Wi S _ ,a Ballasts : Na HydroNa otDevicea or E u Hydromassage Bathtubs No.of Motors Total HP a ecomm, , ; , „ ivalent OTHER: Na of Devices or E.u ens yrj /� Attach additional detail lfdesfned,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: 3 .5f' 2t —=•�--- (When required by municipal policy.) 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"co „ undersigned certifies that such coverage is in force,and has exhibited 0 OTHER 0 proof tf same to the°or its subs ng offigtoffice. o equivalent. The CHECK ONE: INSURANCE?a BONDpermit issuing I certljy,under the pains and, nobles o (Specify;) • FIRM NAME: jpey .'' � e information on thJa JJeation istrue and eonrpI ,., Licensee: q g LIC.NO.: 8 3012 (Ifapplicable.enter"exempt"in the license number line./ Signature Address: LIC.NO.: *Per M.G.L.c. 147,s.57-61,security work requires Bus.TeL No.• v- -077 o ublic OWNER'S INSURANCE WAIVER: I am aware that does not have the liability insurance coverage 1 required by law. Bymysignature "S"License: Lic.No. reSiquire ens below,l hereby waive this requirement. I am the(check one I owner • g normally ownersa:ent. Telephone No.