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Home My WebLink AboutBLDE-21-006499 Official Use Onlof y Commonwealth of "M Massachusetts Permit No. BLDE-21-006499 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:5he/n1°/202 of Wires: City or Town of: YARMOUTH By this application the undersigned gives notice of his or her intention to pert' the electrical Location(Street&Number) 585 ROUTE 28 too Telephone No. Owner or Tenant ZAMBELIS EVANGELIA K TR Owner's Address WHY ME REALTY TRUST, 585 ROUTE 28,WEST YARMOUTH, MA 02673 Appropriate Box) Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Purpose of Building Utility Authorization No. Volts Overhead 0 Undgrd 0 No.of Meters Existing Service Amps New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Modify existing fire alarm system. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.Susp.(Paddle)Fans No.of formers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Emergency Lighting No.of Luminaires Swimming Pool grnd e ❑ grnd. ElBattery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices Total No.of Alerting Devices No.of Ranges No.of Air Cond. Tons Heat Pump I Number I Tons I KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices 0 iVlunici al No.of Dishwashers Space/Area Heating KW LocalConnection 0 Other: Security Systems:* No.of Dryers Heating Appliances KWNo.of Devices or Equivalent NoNo.of No.of Data Wiring: He Water KW Siens Ballasts No.of Devices or Equivalent Heaters Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of ires. 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 CI (SPeci (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: JAMIE S POPILLO LIC.NO.: 7017 Licensee: Jamie S Popillo Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:6 Amanda's Trail, South Dennis MA 02660 *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 ❑ owner's agent. I Owner/Agent I PERMIT FEE: $115.00 Signature Telephone No. -. rye IZth Comnooaiusa /this:: os& Official Use Only � c^� / Permit No. '��- G`-n r f� .Usfrar�ixsnl°l ""` trutc Occupancy and Fee Checked f BOARD OF FIRE PREY NTION REGULATIONS [Rev.1/07j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in 4WAJIRLaw.with the Massachusetts Electrical Code WW1 527 CMR 12.0E INK OR ALL INFORMATION) Date: 5 1,1?I im. E or Town � C len0t) V1r City or of: To the Inspector of Wires: By this application the undersigned gives notice of his her intention,to perform the cal work described below. Location(Street&Number) 6 tons . Y�►- arras L'� h Owner or Tenant eft. , U,ISl Ot)flacU5 e :frpriwSTelephoneNo. V.� Owner's Address ..+ Is this permit in conj c�tionn with a building permit? Yes KJ No 0 (Check Appropriate Box) Purpose of Building C.011 I►t t✓' Utility Authorization No, Existing Service Amps I Volts Overheard 0 Undgrd E. No.of Meters ,, New Service � . Amps i Volts Overhead 0 Undgrd 0 No.of Meters — Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: filti'ii %*1[e. L} la Completion of the followingstable may be waived by the Inspector of Wires. es. No.of Recessed Luminaires No.of CelL-Snap.(Paddle)Fans Transformers Total CI No.of Hot Tubs Generators KVA No,of Lumiaalre OutletsPool Above ❑ in. rto,of envy Lighting No.of Luminaires Swimming grad. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Detection and No.of tomes No.of Gas Burners Initiating Devices 1No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons No.or Self-Contained That?unlit r� Number TonL....I.? '......«.«. No,of Waste Disposers Totals:I »«..««.«.«.« ««.«« DCmction/Ale 4 r Devices ( Mun W 'No.of Dishwashers Spac e/Area Heating KW Local 0 Connection 0 Other No.of Dryers Heating Appliances KW Nayof*s or Equivalent No.of Water No,of No.of Data Wiring; Heaters KW Signs Ballasts No.of Devices or Equivalent "TelecommunicationsW No. Hydromamsge Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value El 'cal Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 cert fy,under pains and penalties ofperfrry,eat te information on this application is true and complete FIRM.NAME I C; (I t LIC,NO.:�D)�� Licensee: rn i( 1 t i_rill 0 Signature I.IC.NO. ,�11't Bus.Tel.No.Y "1- (if applicab -{ 0" nipt" the yi.u,+ bar line') Alt.TeL No.: Address; w,{ )C ( r�t c .t /d S �fPublic Safely"S"License: Lic.No. *Per M.G.L.c. 147,s.57-61,security wo requires DepartmentOWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coveragnormally .aget required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner Q owner's Owner/Agent Telephone No. I PERMIT FEE:$ 1)6.` I Signature