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Home My WebLink AboutBLDE-21-003700 4' Commonwealth of Official Use Only ,lft`. , Massachusetts Permit No. BLDE-21-003700 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:1/5/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 255 LONG POND DR Owner or Tenant KOSSIFOS HELEN N Telephone No. Owner's Address KOSSIFOS CONSTANTINE N,255 LONG POND DR, SOUTH YARMOUTH, MA 02664-4181 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ap opriateilox) Purpose of Building Utility Authorization No. 2 Existing Service 100 Amps Volts Overhead 0 Undgrd 0 o. s ....L.C..' New Service 200 Amps Volts Overhead 0 Undgrd 0 o.'�4' , Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service. /v ) le71s:.Completion of the following table may b Irctor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers D A No.of Luminaire Outlets No.of Hot Tubs Generators A No.of Luminaires Swimming Pool Above ❑ In- 13No.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 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. 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: Eric R Scannevin Licensee: Eric R Scannevin Signature LIC.NO.: 53003 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:54 ROCKY HILL RD, BREWSTER MA 026311631 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: $50.00 /� t' Ca wwa lt(o`Maeeachir.M& Official Use Only - Permit No. u " ''7 oc _s7.,.‘,..,1parfw / �ir. Occupancy and Fee Checked 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(MF,C),527 CMR 12.00 c (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 12)3/02-o 2-0 a.' City or Town of: y co'fA of%-h 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) / 5-5 L_o 1,y iOa,vJ DriIne '-)' Owner or Tenant Dino k 0 SS i fc Y Telephone No. -- a 0 Owner's Address <' i n Is this permit in conjunction with a building permit? Yes 0 N - (Check Appropriate Box) cPurpose of Building 1)(A/OA,v� Utility Authorization No. 1 I o 5 3 C. Existing Service /eo Amps l I 0 / 19-b Volts Overhead E- Undgrd❑ No.of Meters / C New Service Z)0___ Amps 1/0 / 4,1-0 Volts Overhead 21.- Undgrd 0 No.of Meters / v Number of Feeders and Ampacity y/D S cu Location and Nature of Proposed Electrical Work: j.Q l/(;C 6.e4111i 1 e A.i J fact-d 01-jt- firOVVV ta) 1-6 AMA vii y Completion of thefotlowtngtable my be waived by the lrT KVA emr of Wires. No.otal W No.of Recessed Luminaires No.of CeIL-Sasp.(Paddle)Fans Transformers �f C No.of Luminaire Outlets No.of Hot Tabs Generators KVA K-1.\ Above In- Ito.of>r:mergency Laguna; k No.of Luminaires Swimming Pool A rad. 0 In-d. 0 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 1:+ No.of No.of Air Cond. Tus l No.of Alerting Devices No.of Waste Disposers "e'tTotalsp Number Toa>< Kw rpo of on/Ale rat nthgpevices No.of Dishwashers Space/Area Heating KW Local 0 C anation 0 Mier No.of Dryers Heating Appliances KW SecNa of Devieess or Equivalent No.of Water , No.of No.of Data Wiring: Heater Signs Ballasts No.of Devices orEquivalent Veil:coNo.Hydromassage Bathtubs No.of Motors Total HP of or E aiv&ot 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: 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,] BOND 0 OTHER 0 (Specify:) I cad&ander the pains and penalties of perfidy,that the information on this applicadon is trete and complete. FIRM NAME: LIC.NO.: Licensee: 4. R-k C 5 C 4 nn{C`i N. Signature LIC.NO.:,5 360 3 3 (If applkable,enter"exempt"in the lkense+lumber link) ,. Bus.TeL No.: SO k- 8'16- 4,e7 1c Address: QoX /TT I i? lbw )k-ti''i M/i- 6 2 4 3 I 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: 1 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 IPERMIT FEE:$ Signature Telephone No.