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HomeMy WebLinkAboutBLDE-20-002757 0. . tisst,---> Commonwealth of Official Use Only t.4. ,I Massachusetts Permit No. BLDE-20-002757 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:11/12/2019 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) 13 LAKELAND AVE Owner or Tenant CARON JOAN HELEN TRS Telephone No. Owner's Address CARON RUSSELL PIERRE TRS, 13 LAKELAND AVE, SOUTH YARMOUTH, MA 02664 40 �) Is this permit in conjunction with a building permit? Yes 0 No 0 (Check '.,o ria /) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 o , •r w New Service Amps Volts Overhead 0 Undgrd 0 No. . ear � 7 Number of Feeders and Ampacity O O ' Location and Nature of Proposed Electrical Work: In ground pool installation.Completion of the following table may be waived b A‘v s ����.////of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of `t " Transformers 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 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.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 ❑ 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: JULIUS PRIZGINTAS Licensee: Julius Prizgintas Signature LIC.NO.: 10408 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:97 CHUCKLES WAY, MARSTONS MLS MA 026481583 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $85.00 COAIDikr Plum L 6MDvnoLt.vto iU<lL,f/ r- /z/t/ ,u/r� 4 c.,26„•�� 4._ cevac/s,,,,,..,. 7(1 o�ic C 0.44._b c rr u7-- to pe (. 2(24('" (Q `=� Ga.o rya r 1 ` T ec�d�( 1 Nil >I '."0J 9 . '-1s ;i + . -.-, C)..0 o aa[th of//Iaee.hi alt, Official Use Only _ it ��. ,_a_�K. �_. .. cc77 Serviced Permit No. L 2p-- 27 5') apartment o`Jxrs Jsrvicse ilrOccupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1l07] (leave blank) U APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK \i All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 k (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /// /?/ /9 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) /3 L 4, eiA/I/p ,9u6 Owner or Tenant C�4.PON ..9019 / �L � 70.e_f Telephone No. (1V� Owner's Address 3i / 0 Is this permit in conjunction witha building permit? Yes No QN El (Check Appropriate Box) ' Purpose of Building "We//y 6 Utility Authorization No. k c; Existing Service /00 Amps //O /jt'OVolts Overhead❑ Undgrd No.of Meters Oo �i New Service Amps / Volts Overhead Undgrd V ❑ g ❑ No.of Meters y l �' Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: //t/ 6'F /v47 ,0 a L tcQL1//7�ivT Completion of the following table may be waived by the Inspector of Wires, i Fans No.of Recessed Luminaires No.of Ceil.-Snsp.(Paddle) 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 — grad. 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 Tons No,of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingMunicipal KW Local 0 Connection ❑ Otber No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters No.of KW No.ofSigns Ballasts Data Wiring: 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: 4 7 el e„tit 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: INSURANCES 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: ,7i ii/tom j /p//c'C//l' 7W LIC.NO.: AO k:1/.6 Licensee: ..X/4/t'J /3'//4"hJ//1 Signature LIC.NO.: e 0‹,(t'2#t (If applicable enter"exempt"in the license number line.) Bus.Tel.No.• S'�.�/i,�'9©/� ' Address: 97e cireic eie /Fr9'/ /Y 'c 70 /Le f 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: 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: $ g-i