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Home My WebLink AboutBLDE-22-001030 Commonwealth of Official Use Only i Massachusetts Permit No. BLDE-22-001030 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:8/24/2021 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) 62 JOSHUA BAKER RD Owner or Tenant ZAMBELIS THEODORE H Telephone No. Owner's Address KOUNADIS EVANGELIA K, 335 MAIN ST,WEST YARMOUTH, MA 02673 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 ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install five(5)smoke detectors 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. To No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 5 Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection 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 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:) A 8— 3 3z /e'q QJ Q� I certify,under the pains and penalties of perjury,that the information on this application is true and complete. ` FIRM NAME: REX A BURGER Licensee: Rex A Burger Signature LIC.NO.: 17037 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:2045 MAIN ST, MARSTONS MLS MA 026481864 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 1114) ofic 8 Zr E ' J .RECEVE..D AUG &3 (-. Official Use Only :.,. Commonwea&of VJamachudaild 'R``-^:' c� c-� n Permit No. '((0 BUILDING D Ei. s� '"T �lJsioar�i»srtf°�,}ira Jsrvicsd ev. ---- 1�'-' Occupancy and Fee Checked 3OARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC),527 CMR 12.00 �1 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: a .5 City or Town of: YARMOUTH To the In ector Wires:of� f�a' By this application the undersigned gives notice of his or her intention to perform the electal work described below. Location(Street&Number)_6 S®s A Q& ()a /K,4 k R L.) # Ya I+00 tatl-L�1,, Owner or Tenant A yt5 f.. Z(2 to //3 1 Telephone No. IOwner's Address 1 Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building b W p I I 1 Utility Authorization No. I Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters Number of Feeders and Ampacity i Location and Nature of Proposed Electrical Work: 5-f.4 ( a Hai efo Lit eft' i r t H t G i�0� 4 ✓ S.till Gl'Q..&' .`to/'S Completion of the followinktable mf be waived by the Inspector of Wires. C1' No.of Recessed Luminaires No.of Ceil:Sttsp.(Paddle)Fans No.o Total ._, Transformers KVA ":t No.of Luminaire Outlets No.of Hot Tubs rA Generators KVA t" 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 r Initiating Devices No.of Ranges No.of Air Cond. Tons) No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of SeTf-Contained Totals:I "� { _Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters ' Data Wiring: No.of 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: LY? o?.I 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 Er BOND 0 OTHER 0 (Specify:) I certify,under thepains and penalties of perjury,that the information on this application is true and complete FIRM NAME: Ham ,lr,y,.r (/ecLv 1[, `C ��c.#ry — LIC.NO.: A 170 Licensee: e Signature LIC.NO.: (If applicable,enter"exempt,"in the license number,line.) Address:ao 4c tbtic,n St. �a45.7�j1„5 M i' M Mn' Bus.Tel.No.:rr 3�a b9$5 Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one owner owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE:$ 5(D`