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Home My WebLink AboutBLDE-22-003115 i Commonwealth of Official Use Only Al% ,\.‘3,,\ Massachusetts Permit No. BLDE-22-003115 BOAR 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:11/30/2021 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) 10 MOSS RD Owner or Tenant Opher Dagon 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 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: In-ground pool. 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 0 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 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 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 Signs 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 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: JULIUS PRIZGINTAS Licensee: Julius Prizgintas Signature LIC.NO.: 10408 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:97 CHUCKLES WAY, MARSTONS MLS MA 026481583 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: $135.00 2/3itjt6r) 614"‘"C(IN‘ Aktell 12,7 I X le V 0 CPO tjA01A16. t 4.t.( i . .qig(z, 1 1 �! NOV z 0 2I ='' 'i Co ttmonrvaatth el///aeeachuaa(te Official Use Only : € r >Ie! p tmsnE o S' Permit No ✓7i2-I r s ar its Serviced - ---- -' 1► `:.. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perfonned in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 11/30 / ?/ 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) /40 was S 3 T Owner or Tenant OP/7/6-e //41 7a i Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No 0 (Check Appropriate Box) Purpose of Building D 6 L//� Utility Authorization No. Existing Service Amps 0 0 /e 4'a Volts Overhead❑ 13 Undgrd 1 g t� No.of Meters New Service Amps / Volts Overhead ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1/(/�r- u 4 /� / es�,ePO/J/IiQ �Ol7e vl Completion of the followingtable m be waived by the Inspector of Wires. �' No.of Recessed Luminaires No.of Cell:Sas . No.off Total 't p (Paddle)Fans Transformers 'Z; No.of Luminaire Outlets KVA No.of Hot Tubs Generators KVA t' No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grnd. grnd. � Battery Units No.of Receptacle Outlets , No.of 011 Burners FIRE ALARMS JNo.of Zones No.of Switches No.of Gas Burners 'No.of Detection and , 1' No.of Ran es Initiating Devices g No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number. Tons KW No.of Self-Contained Totals:I .. Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipar No.of Dryers Connection �� iY Heating Appliances KW Security Systems:* No.of Water KW No.of No.of Devices or Equivalent HeatersNo.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work toted (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 c,o�v ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE L"J BOND 0 OTHER I certify,under the pains and pens/ties o 0 (Specify:) FIRM NAME: ,� fperjury,that the information on this application is true and complete. � E e /Y/CAZ /'0 / i9C TGrjer G C LIC.NO.:- �,� Licensee: ,7� /U / 4"zteitS Signature 1,d•L(If applicable,enter"exempt in a License number line.) LIC.NO.: O O P Address: .90 c U -- �y / Alt- Bus.Tel.No.� p/�� *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S'�a set Lic.No. Alt.TeL 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/Agent owner ■ owner's a:ent. Signature Telephone No. PERMIT FEE:$ /3 5