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Home My WebLink AboutBLDE-22-005800 ID Official Use Only Commonwealth of Permit No. BLDE-22-005800 Massachusetts 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 1N INK OR TYPE ALL INFORMATION) Date:4/11/2022 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) 36 JOHN HALLS CARTPATH VI Telephone No. Owner or Tenant George Hadjimina Owner's Address 36 JOHN HALLS CARTPATH VILL,YARMOUTH PORT, MA 02675 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: Finish basement. 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 Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Av No.of Emergency Lighting No.of Luminaires Swimming Pool grnbod.e ❑ In-grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump I Number 1 Tons I KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices 0 Municipal No.of Dishwashers Space/Area Heating KW LocalConnection Other: Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or Equivalent NoNo.of No.of Ballasts Data Wiring: He Water KW Signs No.of Devices or Eauivalent Heaters Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Eauivalent 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 El (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Russell L Haden LIC.NO.: 36613 Licensee: Russell L Haden SignatureBus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:36 CAPTAIN STUDLEY RD, MARSTONS MLS MA 026481265 *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 ownbiler ity❑ins ranee csoverage normally required by law.But my signature below,I hereby waive this requirement.I am the(check one) t. Owner/Agent PERMIT FEE: $75.00 Signature Telephone No. ,---7 ,,L,,,,,,6_-e,_ s<<.4 . RECEIVED Cj71 �V LDS C1 CQ APR 112022 R-ec(6(4 Commonwealth.o` aaaachaastta Official Use O BUILDING DEPAN1 � ` BY ___..._-- : ' 7' cc�� c7 nn Permit No. G•�- -tp.;�; r. 2spartmsnt o`3ins Jswicsa r'µ Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07]4 01 (leave blank) , 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: —6/- Z7,- City or Town of: ''YARMOUTH To the Inspector of Wires: By this application the undersigned gives notic � of his or her intention to perform the electrical work described below. Location(Street&Number) 31� �� w f'/' Owner or Tenant �/�( 4.—C� 7 fip(Wry-Telephone No. Owner's Address S �{ Is this permit in conjunction with a building permit? Yes EJ No ❑ (Check Appropriate Box) Purpose of Building aeS7-b`E",vl,C Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd E] No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: t J(S'0 �;1-s&2-t Nrr" 0,; kt'i' Completion of thefollowingtable may be waived by the Inspector of Wires. "` No.of Total U, No.of Recessed Luminaires No. Ceil.-Susp.(Paddle)Fans 4,/ um ofTransformers KVA _ '=Z:t No.of Luminaire Outlets No.of Hot Tubs Generators KVA <t°° No.of Luminaires SwimmingPool 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 II t No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump ....,umber _Tons_ _ KW 'No.of Self-Contained Totals: ` '' "' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipa ❑ Other, Connection No.of Dryers Heating Appliances KW Security Systems:1 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: 3/ 5 i9_ (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 cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [BOND 0 OTHER 0 (Specify:) I certify,under the p ns and penalties of erjury,that the information on this a ication is true and complete. FIRM N �/ C �( C LIC.NO.: Licensee: •(,4t�j.C` L L Signature IC.NO.: 3k,6/3 c Ofapplicabl enter 'exempt"in the license number line.) Bus.Tel.No.• Address: 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 law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner []owner's agent. Owner/Agent bD Signature Telephone No. PERMIT FEE:$ 7S_