The URL can be used to link to this page

Home My WebLink AboutBLDE-22-0053021 � � Commonwealth of Official Use Only ' Massachusetts Permit No. BLDE-22-005301 , - ; 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:3/23/2022 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) 610181 SOUTH ST Owner or Tenant Bohage Asakev 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 ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for"shed" 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 6 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 5 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Ton l No.of Alerting Devices 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 ❑ Connection Municipal 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent 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: Sami S Mezian Licensee: Sami S Mezian Signature LIC.NO.: 40505 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO Box 869,Westwood MA 020900869 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 4 'r'Ou7- c1/64z-"2-- 6-0-0914040" rra w c ,sLavzam q/( ` � 11 erica v / -t-c i / -(tip 1 i C EI _E 11/ �� MAC 22 1.- q nwaa[th zazz A' , , of Maddaclfd Otlicial Use Only r:': , vi,�� rr�art�nn E35, CC�� Permit No. ZZ � u - 3O nE o`.giro Jarvtcad S % BOARD OF FIRE PREVENTION REGULATIONS 'panty and Fee Checked [Rev. I/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 R IC rPLEASEPRINT ININK OfRof TYPE ALL INFORMATIONI City or Town Date: i sy this application the undersigned givYARMbis orOUT tention to To the Inspector of Wires: perform the electrical work described below. Location(Street&Number) • Owner or Tenaat c �—'� a r�1 r_z 1^ c c / �� Tel Owner's Address Telephone No. - C permit in conjunjn with a building permit? Yes 0 No purpose of Building �` ./ 0 (Check Appropriate Box) Utility Authorization No. !xisting Service Amps / Volts Overhead ❑ Uudgrd 0 No.of Meters _ Amps / Volts Overhead 0 Undgrd Number of Feeders and Ampadty ❑ No.of Meters Location and Nature of Proposed Electrical Work: • Com,/etion o the ollowi : table m, be waived, the In , for o Wires. e No.of Recessed Luminaires Na of Cell.-Sow,(Paddle)Fans Transformers ota KZ; Na of Lumiaaire Outlets Na of Hot Tubs KVA 4' Na of Luminaires Generators KVA F Swimming Pool ,, ' de ❑ n- 'o.oe virulency , , ;n No.of Receptacle Outlets °d• ❑ Butte Units g .,.. No.o!Oil Burners No.of Switches No.of Zones No.of Gas Burners.v. `a o t tee,on an e 1!.r No.of Ranges Init iadn Devices No.of Air Cond. ota Tons No.of Alerting Devices o.of Waste Disposers 'eat nmp •..urn,-r -op. `o.o on n , Totals: _ Detecdon/Alertln Devices No.of Dishwashers Space/Area Heating KW Local un No.of Dryers Heating Appliances u Connection 0 Otber KW yatema: o.o No.of Devices or .uivalent o.o Hearter s KW S,_ s Ba.o Da a Wiring:No.Aydromaasage Bathtubs a of Devices or E.uivalent No.of Motors Total HP a ecommun a s ,ns 'T ,gg• OTHER: No.of Devices or ' .uiva7ent Attach additional detail lfdeslred,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 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"completedoperation" signed certifies that such coverage is in force,and has exhibited roc of same to thee or its substantial equivalent. The CHECK ONE: INSURANCE IN BOND OTHER ❑ (Specify:) p permit issuing office. I met,under the pains and naldes o FIRM NAME: (perjury,that the injoraration on this application is true and complete Licensee: fM t" LIC.NO.: t /"J •7 ' Signature (Ifapplicable,enter exemp in the license number line `~ Lam-- LIC.NO.. , Address: ._�. '4t. C�. t._ "Per M.G. .c. 14 s.57-61.security wo requires Bus.TeL No.• rW Department of Pub is Safe ''�K•Tel No.• 's"`r� V�.�/ OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance overage normally-' regi iced by law. By my signature below,I hereby waive this requirement. I am the(check one II owner a owner's a:e Signatureeat nt. Telephone No. PERMIT FEE:$