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Home My WebLink AboutBLDE-22-003719 oft. Commonwealth of Official Use Only iL, E` !�i Massachusetts Permit No. BLDE-22-003719 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:1/5/2022 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) 4 BALDWIN LN Owner or Tenant DEIGNAN PAUL F Telephone No. Owner's Address DEIGNAN REGAN,4 BALDWIN LN,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: Bathroom remodel Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 3 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 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 3 No.of Gas Burners No.of Detection and Initiatine 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/Alertine 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 Eauivalent 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 my 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 '08 / ' t1,11/4PAC &ag Cemmonwsa[i 4 S....d M7aedaae Official Use Only ' 'l 2eparlon .nl.,' . Permit No. IiZZ (CI • : 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 TYPEAAL INFOR TION) Date: 07 0 cT City or Town of: a'^,(:7OZ To the Inspe for o Wires: By this application the undersigned gives notice of his or intention to perform the electrical work described below. Location(Street&Number) I C•..L W/)/ iv/ Owner or Tenant ray/ V i`e 'tam Telephone No. ,(,70,3-9_93-1f] f Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Boz) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity kLocation and Nature of Proposed Electrical Work: rig dvroc744 1C e/ n Completion of the followinktable my be waived by the I7ecfor of Wires. eiN. No.of Recessed Luminaires 3 Na of Cel. (Paddle)Fans No.of Total 'gyp•Ti Transformers KVA Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA ''` Swimming Pool �Above Ia- No.of Emergency Lighting 4 No.of Luminaires � ❑ gmd. ❑ Battery Units � x No.of Receptacle Outlets Z No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches `3 No.of Gas Burners 'No. °l)kwkes l'` No.of Ranges No.of Air Cond. TotalNo.of Alerting Devices Tons No.of Waste r: Heat Pump Number Tops_ 'Ro.of Self-Contained Totals: ._ KW r_... - Detection/Ale • ,, Devices No.of Dishwashers Space/Area Heating KWLocal❑ Connection 0 Other No.of Dryers Heating Appliances KW SNo.ofecurity yo 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 TelecommunicationsNo.of Devices or& nt OTHER: 1.561 t/ NI Attach additional detail if desirect 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 0 BOND 0 OTHER 0 (Specify:) I ca'dfy,ander the pains and penalties of ary,that the information on this application is true and complete. L LIC.NO.: FIRM NAME: Z P'Ctr't a. ‹er..�f1 ceS l { �__ ._ y., Signature ` - ,,--'V4-1",6.._, 'r',2 Licensee: �/� �/'�v iS� LIC.NO.: (If applicable,9trter' t"in the license number line.) Bus.TeL No.: Address: {'.62 AUX, 112./;q , , .iillii> / (,' 7 ) Alt.TeL No.: ' Per M.G.L.c. 147,s.57-61,security work requires Departmebt 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)❑owner 0 owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.