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HomeMy WebLinkAboutBLDE-22-000850 a... Commonwealth of Official Use Only i. Massachusetts Permit No. BLDE-22-000850 BOARD OF FIRE PREVENTION REGULATIONS Occupancy p y and Fee Checked Rev.1/07 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK W All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 vv Old (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) /16/2021 City or Town of: YARMOUTH Date:To the Inspector By this application the undersigned gives notice of is or ter intention to perform the electrica work described below. of Wires: Location(Street&Number) 5 ZEPHYR DR Owner or Tenant Glenn Martin No. Owner's Address PANAGIOTOPOULOS CAROL A, 5 ZEPHYR DR, YARMOUTH PORT, MA1ephone 02675-372 Is this permit in conjunction with a building permit? Purpose of Building Yes 0 No 0 (Check Appropriate Box) P Existing Service Utility Authorization No. Amps Volts Overhead ❑New Service Amps Undgrd 0 No.of Meters Number of Feeders and Ampacity Volts Overhead 0 Undgrd 0 No.of Meters Location and Nature of Proposed Electrical Work: Correct code violations on work done b others. Completion of the following table may be waived by the Inspector of Wire: No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Transform•rs Total No.of Luminaire Outlets No.of Hot Tubs VA Generators KVA No.of Luminaires SwimmingPool Above In- rnd. ❑ rnd. IDNo.of Emergency Lighting No.of Receptacle Outlets No.of Oil Burners Batter nits FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges No.of Air Cond. Total Init'atin. D•vices No.of Waste Disposers NumberTons ns Heat PumpNo.of Alerting Devices Total : KW No.of Self-Contained No.of Dishwashers --Detection Alertin. Devic•s Space/Area Heating KW Local 0 Municipal No.of Dryers C nne tion ❑ Other: Heating Appliances KW Security Systems:* No.of Devi e 'r E i uival•nt No.of Water KW No.of Heaters No.of Ballasts Data Wiring: i.ns No.Hydromassage Bathtubs No.of Devices or E i u'va ent No.of Motors Total HP Telecommunications Wiring: OTHER: o. i f De i •s or E i ivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work to start: (When required by municipal policy.) to be requested in INSURANCE COVERAGE:Unless waivedinspection by the wne,no permit for the performancen ce hof electrical work m MEC Rule 10,and ay piss completion. 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. y issue unless the licensee provides CHECK ONE:INSURANCE 0 g BOND 0 OTHER 0 I certify,under the pains and penalties o (Specify:) FIRM NAME: (perjury,that the information on this application is true and complete. Licensee: Joshua Jones Signature (If applicable,enter"exempt"in the license number line.) LIC.NO.: 55825 Address: 6 Pine Tree Circle,Sandwich MA 02563 Bus.Tel.No.: 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 bylaw.Bu signature below,I hereby waive this requirement.I am the(check one ) ❑ owner 0 owner's agent. t my Signature Telephone No. 4(z4I PERMIT FEE:$75.00 lGem L E(4 s Co mmonwaa/K o f Vadoacliuealle Official Use Only _ =. 0_« cc�� c�77 [� Permit No. �� 'Z2--40 E� _ a1Jafa, ino. o/.}ira Janvecaa `:='�`�= Occupancy and Fee Checked `'y,;� F ^' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFO TION) Date: g/f 3/2 ( City or Town of: llaliiMC4-d 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) - 2 er ifi v {r Owner or Tenant 61 e vi A h Telephone No. 561"277-ti1Ol Owner's Address 5 2e1,14 yv- i'r. (r e 1 A 0;6 7 5 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building 3.1 .a-n rc, le C-cc/e Utility Authorization No. Existing Service Amps / Volts Overhead❑ 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: Act,4 6,,„).-1 e K 4r 4-ci 6 Or C.e S S G.,tie i- Completion of the followinyitable may be waived by the Inspector of Wires. Totallo.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Transformers KVA KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grad. 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. Ton No.of Alerting Devices 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❑ Monn unicipaltion El Other Cec 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 Wirin No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electra Work: — (When required by municipal policy.) Work to Start: i(-( I 3l ( 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 ❑ OTHER 0 (Specify:) I certifr,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: S cSL,-4 c- S '-LOc i,•,`c "� LIC.NO.: '51jDI; (3 Licensee: 7c-cs1.1 1---,,....e> Signature LIC.NO.: 5--j k2- 13 (If applicable,enter "exempt"in the license number line.) Address: Bus.Tel.No.: 77-61,-t©1 *Per M.G.L.c. 147,s.57-61,securitywork Alt.Tel.No.: 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. fly my signature below,I hereby waive this requirement I am the(check one)0 owner ❑owner's agent Owner/Agent Signature Telephone No. I PERMIT FEE:$ I