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Home My WebLink AboutBLDE-21-003967 il'0 Commonwealth of Official Use Only k Massachusetts Permit No. BLDE-21-003967 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:1/19/2021 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) 9 JOHN HALLS CARTPATH VIL Owner or Tenant Susan Cowmeadow Telephone No. 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 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 bathroom. Completion of the following table may be waived by the Inspector of If gyres. No.of Recessed Luminaires 1 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- O No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 3 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: 1 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. 4, Z i Z 393— (� CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) 7 � 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 Telephone No. PERMIT FEE: $5,625.00 �� ( 17�i 6 t/ fi,�n, O It /3/z, ua ( `i/ u k6- C..om+nonwsa[th al�aeaachuasfld Official Use Only _„ _ .21 —3`?l 7 ,�_��r , cc�� 7 nf� Permit No. -,, . 2eparimsnl a "ire Jswices `:ry, Occupancy and Fee Checked h BOARD OF FIRE 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 TYPE ALL INFORMATION) Date: -(/(5/7v,-( City or Town of: yu/tk./," i( 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) 3 _‘24/i Rail (- If J Owner or Tenant Si rczCy �i li<tLtPGtt [JLa Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes Er No ❑ (Check Appropriate Box) Purpose of Building I4de4 hit/ Utility Authorization No. Existing Service ,60& Amps (yam,/ 2*, Volts Overhead n Undgrd E No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: e-,i`LC r'CUG e/ $, V) Completion of the following_table may be waived by the bupector of Wires. t.11 No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Trof Tot l ( Transformers A A �/ '1 No.of Luminaire Outlets 4/ No.of Hot Tubs Generators r1 4. e No.of Luminaires Swimming Pool Above In- No.of Emergency cy _ f g grod. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets 4' No.of Oil Burners FIRE ALARM' N .of Zones ci l No.ofDeteci,nai'i `�4A., (/' Z. No.of Switches No.of Gas Burners Initiatin• t••vi® l U No.of Ranges No.of Air Cond. Tons No.of Alerting I . 4Zap/4 4`3f Heat PumpNumber.. Tons KW No.of Self-Containe' No.of Waste Disposers Totals: Detection/Alerting Dev -.... Oc) No.of Dishwashers Space/Area Heating KW Local❑ Myonn Connection n ❑ ' ' • T No.of Dryers Heating Appliances KW Secstems:* urity 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: I No.of Devices or Equivalent OTHER: i .�IA l4t/Z Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: CY' (When required by municipal policy.) Work to Start: .(12 , 0( Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE GE: 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 V BOND ❑ OTHER 0 (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Li}-Z e4- c I i -fjyC� il.Z_ LIC.NO.: Licensee: L,i 2A f? 1-6-k1/ Signature LIC.NO.: -6((e(2,-r (If-applicable,enter exem t"m the license number line) Bus.Tel.No.: Address: P12 • (219 i 12euiiif - -` Fl 026: Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Publi " ' c 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. 1 am the(check one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. , - • \ „ ,,,-*'-t-4,.. • ,` rt. 3 ems:' . '7 3: y.. } 1 a r _ . ; = .t :;- . r: -.' - ,. ,a t �' 'fi _ J = ' ;;ifs/ 1..1` 4, j ± - -