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Home My WebLink AboutBLDE-21-005654 U Commonwealth of Official Use Only Lt. , Massachusetts Permit No. BLDE-21-005654 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:3/31/2021 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) 1261 ROUTE 28 Owner or Tenant TWELVE SIXTY ONE BASS RIVR RLTY LLC Telephone No. Owner's Address 7 CENTRAL ST, SOUTH EASTON, MA 02375-1040 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: Final inspection for remodeled rooms. 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 • /,A KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emer enc, t _1 grnd. grnd. Battery Un' No.of Receptacle Outlets No.of Oil Burners FIRE A N r. IN, • No.of Switches No.of Gas Burners No.of Detec Initiating Devic• O No.of Ranges No.of Air Cond. Total No.of Alerting Devi es Tons 4-4p4V No.of Waste Disposers Heat Pump Number Tons f KW No.of Self-Contained 4°P, Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 MunicConnection 0al . No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens 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: BOLESLAW BOJARZYNSKI Licensee: Boleslaw Bojarzynski Signature LIC.NO.: 19182 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:72 CRESTFIELD TER, BROCKTON MA 023023443 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: $200.00 `` ( pocos4.14 9 4(9/2 r n t` CommonursaW&ejaeeaeIeuestie Official Use Only 1• 'f/ 1 cc'�� cJ��u Permit No,a� — ■ 2spariment e ip`&rvicse ! <' Occupancy and Fee Checked s. 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: M lk12 • t 1 . Zm 7_ City or Town of: 5(kl- 'U2 GC-04 0 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) i 2.. 6\ 12 G t4 2 s S Q LC c1-t f/VGtiWiC .7 Owner or Tenant S p tF Telephone No. J0.Y 31y Z 3(I Owner's Address SJ�wt,. • Is this permit in conjunction with a building permit? Yes 7"" No ❑ (Check Appropriate Box) Purpose of Building kit OT ,C, Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampaclty Location and Nature of Proposed Electrical Work: o c) j 4(.. (a 0-00S i Al2 r,I IA-C M iii t .6ci i- Wl:.- CC V G-2A� �r 12(,)1 tZc t 29 Ste._'k y/�wN4Qc2—'1'( Completion of the following.table NW be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tof TraaonKVAsformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmin pool Above In- No.of Emergency Lighting g grad. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 'No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Ton` No.of Alerting Devices No.of Waste Disposers Heat Pump Number_Tons KW_ No.of Self-Contained Totals: '" ' Detection/Ale j!Ing_Devices No.of Dishwashers Space/Area Heating KW Local 0 nun= 0 Other Co 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 ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: t bhp — (When required by municipal policy.) Work to Start: M Odi, '[ ZInspections 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:) 1 a\(62 C I certify,under the pains and penalties ofPO seryl that the information on this application is true and complete. FIRM NAME: BO(,' _._S LA-GU l k-i�2st N S.k,<.„‘ LIC.NO.: IQ t Cep 2 Licensee: l R I A CT 1'11,(,e,J Signature LIC.NO.: Of applicable,enter"exempt"in the license number line.) Bus.Tel.No. • Address: 7 2 G'2 c S;r i i Lb -TU.. fS)20 CIDA) N 4k 0 23 n 2 Alt.TeL No.: � 51 8 6-5'j *Per M.G.L.c. 147,s.57-61,security work requires Department of Public 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 .r------ _ Signature ,_ ��r,L,,r L Telephone No. SO $ •310 st'Sbl PERMIT FEE: $ \