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Home My WebLink AboutBLDE-21-007137 b Commonwealth of Official Use Only fi_ Massachusetts Permit No. BLDE-21-007137 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:6/9/2021 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) 585 ROUTE 28 Owner or Tenant ZAMBELIS EVANGELIA K TR Telephone No. Owner's Address WHY ME REALTY TRUST, 585 ROUTE 28,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Purpose of Building Appropriate Box) 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 Location and Nature of Proposed Electrical Work: Wiring to interface fire alarm with lighting&sound systems. 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 I 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 I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent 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 0 BOND 0 OTHER 0 I certify,under the pains andpenalties o (Specify:) f perjury,that the information on this application is true and complete. FIRM NAME: REX A BURGER Licensee: Rex A Burger Signature Tel. NO.: 17037 (If applicable,enter"exempt"in the license number line.) Address:2045 MAIN ST, MARSTONS MLS MA 026481864 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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. j� �,� PERMIT FEE:$80.00 A (�l (6(2k m iCommonwsa[h o/Maedachuertte Official Use Only 1, x "='t `� t'� �7 Permit No. ( C1 (37 • epartineni el giro Serviced BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked �'' 4' _ 7 [Rev. 1/O7j (leave blank) 6 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 '4 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: May a 7 a 0 a,I City or Town of: yQ/'PI U To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. 14 Location(Street&Number) SS5 /14 ei t h �7 e we.5* yu rrno M A J Owner or Tenant h 1 it Z c2 rN id qt. (I 1 S Telephone No. 43 Owner's Address J Is this permit in conju ction with a building permit? Yes ❑ No 9 (Check Appropriate Box) IV! Purpose of Building KeS+c t.,rq WI- � Utility Authorization No. i Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters t', New Service Amps / Volts Overhead ElUndgrd❑ No.of Meters , Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: W r p t, r e os.j , ..so kith t h o(t n•a d . < yO fU 41( brt5kt too ktat firt. Ctlot►ot ES i4cf4„�- old r'e/aj It, Lake) aE) Completion of the followingtable may be waived by the 1 for of Wires. No.of Recessed Luminaires No.of Cell.-S No.of l asp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- 1 o.of Emergency Lighting Sind. grad. ❑ 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. Toons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons i KW No.of Self-Contained Totals: _..._____.___.......... ...._ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection 0 No.of Dryers Heating Appliances KW 'Security Systems:* of No.of Devices or Equivalent No.of Water No. Heaters ' No.of Data Whin Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Estimated Value of Electrical Work: bbo-pv Attach additional detail if desired,or as required by the Inspector of Wires. Work to Start: (When required by municipal policy.) 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 certify,under the Aains penalties of erj ,that the information on this application is true and complete FIRM N ex )Vrs — le �a 4Q Licensee: 0 LIC.NO.:/4 (7 0 3 7 Signature �=�1 LIC.NO.: (If applicable,enter exempt"in the license number line.)_ ' o Address: ,� ,N S f Mdt 1 M� I 0 a` Bus.Tel.No.� No *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Sa ety"S"License: Alt.Lie•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/Agentowner's a ent. Signature Telephone No. PERMIT FEE:$