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HomeMy WebLinkAboutBLDE-21-003969 o' Commonwealth of Official Use Only Eit s Massachusetts Permit No. BLDE-21-003969 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•1/19/2021 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 esc ibed below. ( . r Location(Street&Number) 6 HERITAGE DR c& Owner or Tenant C 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 1st&2nd floor bathrooms. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 2 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 2 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 2 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 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No No.of Devices or Equivalent HeatersWater KW No.of No.of Data Wiring: 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: 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:$75.00 *a_066§ *24 a. (--(7,v-44-__ Act6 __._, , 1 r- « Commonuiaa/ o/h rl/a�sac Lie Official Use Only r` t �C Ja rl»unt o gins Services Permit No. �� —3c 1 l irvices 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(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPLL INFORMATION) Date: City or Town of: ICAT-t 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 ffe[ . ye_ fh-/ .6/ Owner or Tenant D?i u.. 1" �'n�r' �o.SS Telephone Na. Owner's Address Is this permit in conjunction with a building permit? Yes El No E (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Ji© Amps ?'2e9/ 2Ilo Volts Overhead❑ Undgrd g Er No.of Meters New Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters Number of Feeders and Ampacity I Location and Nature of Proposed Electrical Work: 66 Il/ ,,,, crUtCl v) u le Qe de �t�/ �c�� tr Completion of the followingjable may be waived by the Inspector of Wires. $ No.of Recessed Luminaires No.of Cell.-Sasp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets a No.of Hot Tubs Generators VA No.of Luminaires 2 Swimming Pool Above ❑ In- No.of Emergency L _ £ grnd. grnd. ❑ Battery Units _ „a No.of Receptacle Outlets Z. No.of Oil Burners ' -,. FIRE ALARMS o of Zon «,�ii , No.of Switches No.of Gas Burners No.of Detectio an ✓� �'` Initiating ',ev es 0 ° No.of Ranges Total g No.of Air Cond. Tons 0), - No.of Alerts�'� Blevi�"� � No.of Waste Disposers Heat Pump I Number Tons KW NO,of Self-Costar= ��, ,,a � r Totals: Detection/Alerting D�.,, , `u G> No.of Dishwashers Space/Area HeatingKW Municipal 4. Local❑ Connection 0 No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No,of Devices or Equivalent OTHER: 2- 6 4 f t.. Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: ,452,552 (When required by municipal policy.) Work to Start: 4 / 7 ,( Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE 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 El BOND 0 OTHER 0 o (Specify:) I certify,under the pains and enalties P, f perjury,that the information on this application is true and complete. FIRM NAME: L fz j7 y-/ .e ,'accjyCe S j�L . LIC.NO.: Licensee: 1._A-p,dl,/ H, iJ Signature F6'/22�5 (I applicable,enter'ez mpt"in the license number line.) LIC.NO.: f pp �� Bus.Tel No.: Address: P o_ ,(Z�'9 rc' ti *Per M.G.L.c. 147,s.57-61,security work requires Department a df b�tSa Safety S License: LiAlt. c.No. H•f> 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$