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Home My WebLink AboutBLDE-21-006925 �or Commonwealth of official Use Only i ,Pi Massachusetts Permit No. B,LDE-21-006925 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:5/30/2021 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) 184 SOUTH SEA AVE UNIT 1 Owner or Tenant YUSKAITIS JOHN T TRS Telephone No. Owner's Address YUSKAITIS MARILYN ANN TRS, 130 WIMBLEDON DR,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Ch Appropriate ) Purpose of Building Utility Authorization No. L) I-t1 rti-lilli 'L30tllC s Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters ( t 0 I A New Service Amps . Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Check building for restoration of service. 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Munonnectio n icipal 0 Other: C No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens 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 (Specify:) i 5-Q 4I certify,under the pains and penalties of perjury,that the information on this application is true and complete. 7 1 FIRM NAME: Gregory Losordo Licensee: Gregory Losordo Signature LIC.NO.: 13564 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 41, EAST SANDWICH MA 025370041 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 ‘,14— '14-7_,( (0,: fut 'by) ((7(21 C1o . sT -etiof wce,Ax0 Commonwealth:0/VaMach-m.4eth Official Use Only /�� is " i�� =rt c� cc77 Permit No. Tleav6:blan::) 7. a2epartment ol..tire Service6 f( - '' Occupancy Fhked ,�_ �� s BOARD OF FIRE PREVENTION REGULATIONS [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 (.a` LEASE PRINT IN INK OR TYPE ALL INFO TION) Date: s Z G j )E, • � ! City or Town of: 'Je-ii 7 To the Inspector of Wires: I m _.�, > y this application the undersignprAft,irrk, ves notice of his or her intention to perform the electrical work described below. i a,,,,r_ __ _1,ocation(Street&Number) l g7 5 a, 5 e4 4ve 11 ocK g6X- Co -- pA Owner or Tenant f'4 ill Q n(' M/A-ke 67 De ve 1apyit281-T-elephone No. `"-e,t 77(o c', Owner's Address 23 /►1 e))(4A LA-N€ /vi 1, ; f 00 Is this permit in conjunction with a building permit? Yes 121 No ❑ (Check Appropriate Box) Purpose of Building VV2 II r� / Utility Authorization No. Existing Service 1 o6Amps t /40 Volts Overhead [ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Co Location and Nature of Proposed Electrical Work: et)Ve R t3ee o-PP () lie 4- -Q,{4 N d I1( - L Ver-CAS J(tQ. Tb kea AJJi-etT" To Q e_6 0 Ai. R eNo V b N Completion of the following table may be waived by the Inspector of Wires. No. Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans TransfKVAormers 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 Detectionn and Inn itiating 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❑ Municipal ❑ 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: I 0 1, (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 ❑ BOND 0 OTHER ❑ (Specify:) I certify,under the ains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: (.0G-0! ,t4 b(d v LIC.NO.: I (0q-g Licensee: CT{� 6C)I L650(t d Signature _ LIC.NO.: 13 5(Y -13 (If applicable, nter Cniptlin the lic�}snumb line.) �' Bus.TeL No.: 77i 3/3 a 1(2, Z Address: X�i h s '"` S fi N�(W, (1. /l,4 d Z�',1 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 la y m signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agen /� C fV^I 11 ad PERMIT FEE:$ Signature �� Telephone No. � ��v"