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Home My WebLink AboutBLDE-22-000221 Commonwealth of Official Use Only 111 Massachusetts r Permit No. BLDE-22-000221 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:7/14/2021 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) 121 CAMP ST UNIT 90 Owner or Tenant Stemani Reis 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: A/C system. 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 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 Initiatine Devices No.of Ranges No.of Air Cond. 1 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 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 Ballasts Data Wiring: Siens 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: ANDREW G THOMAS Licensee: ANDREW G THOMAS Signature LIC.NO.: 22152 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:7 ECHO LN, CHATHAM MA 02633 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: $50.00 q ommonwea o/fi'la.1daciLsetta Official Use Only Fc E C . C Pt� rd �°' t�2Z p2Z ^:¢A�` cc�� cc77 Permit No. 2)epartment o/.}ire�erviced JUL ,‘V47,witi ,. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 BU1LDfNG DEPARTMENT (leave blank) BY'--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: 7/ 1)/4 7 City or Town of: ,crc bsowi 1, To the Inspector of Wires: By this application the undersigned gives notice of his or her intentionntto perforn the electrical wo -de ibed below. Location (Street&Number) 1) I C co 5 f tic I ( t. 0 Owner or Tenant S4-1.t/44"; (: Telephone No. Owner's Address Id l C co r 54-ft-c-f Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building ��)`a cnt r Utility Authorization No. Existing Service IOC) Amps 110 / 240 Volts Overhead ❑ Undgrd I g � No. of Meters New Service Amps / Volts Overhead❑ Undgrd fl I No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: A G adz ov 13 t-{ 0,- Cv,4ntt l 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 KVA I 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 INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. t Tonsl No. of Alerting Devices No. of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals:J I. f Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection Other No.of Dryers Heating Appliances KW Security No.of Systems:* No.of Water 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: ! Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: o,Lk) (When required by municipal policy.) Work to Start: /)2/ 1 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 izi BOND ❑ OTHER ❑ (Specify:) 4(9 •'g3S,... 8793 I certify,under the pains and penalties of perjug,that the information on this ap lication is true and complete. FIRM NAME: `T1toI S �.t ell,Lkl ct(�/,C�J ��v 11 cS ,��L LIC. NO.: 2 I S 42-4 Licensee: ! '4 d.f cv Signature (If applicable, enter "exempt"in the license number line.) LIC.NO.: Address: k��u 1qn{ �� ti�;(1 Bus. Tel.No.: 17 `S)� .793 *Per M.G.L. c. 147, s. 57-61,security work requires Department of Public Safety"S" Alt.Tel.No.:_________________ OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have liability insurance coverage normally required by law. By my signature below.I hereby waive this requirement. I am the(check one)❑owner Owner/Agent El owner's a ent. Signature Telephone No. PERMIT FEE: $ CIC I'S-3?