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Home My WebLink AboutBLDE-23-000721 Commonwealth of Official Use Only L, ;I 1 Massachusetts Permit No. BLDE-23-000721 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:8/11/2022 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) 193 SOUTH SEA AVE Owner or Tenant YUSKAITIS MATTHEW Telephone No. Owner's Address YUSKAITIS DAWN, 193 SOUTH SEA AVENUE, WEST YARMOUTH, MA 02673 Q Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropna ,j Purpose of Building Utility Authorization No. f/ Existing Service Amps Volts Overhead 0 Undgrd ❑ • . .r New Service Amps Volts Overhead 0 Undgrd 0 No. i Ta_ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Rebar grounding ' 4;),/ 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 Initiating Devices No.of Ranges No.of Air Cond. Tons Tota 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 ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* y No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LONGFELLOW DESIGN BUILD Licensee: Jeromme Marques Signature LIC.NO.: 22751 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:26 Lake Avenue,Woburn MA 01801 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: $50.00 kt '1)1,, 4 'arc), C — Nk e ( lN q )ef_, tt(( \L. O. C; r C-- RECEIVED ,w __ ®®/ �//q // Official Use Only/� . -_ _.._�_ . i ommonwealth o/�addachudetid ".Official b�Only d� lal-0_04- 1 1 2022 Permit No. ( I = b a artment o f Sire Serviced �— P andFee Checked _ ;t= / _ _ Occupancy Ch ck �' `-�-'-,�'rw r IRE PREVENTION REGULATIONS [Rev. 1/07 t= j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Clock(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 6 )/l� Z 2_ City or Town of: V/rit 4G( 17 To the inspector of Wires: By this application the undersig$'ed gives notice of hi or her intention to perform the electrical work described below. Location(Street&Number) l 3 SQv,/ S(0.7 Ai-vP Owner or Tenant 4,- /4-]eh /¢-/11/S Telephone No. 5T-V 2-03 952-4 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building S/424,4 /—/,N/• 4/ Utility Authorization No. Existing Service 2 a 0 Amps 9 2. /2 y molts Overhead ❑ Undgrd❑`-- No.of Meters i New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: j,E4ft �J�ti,,3/4.om y 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 Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices Total No.of AlertingDevices No.of Ranges No.of Air Cond. Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipalri Connection ❑ Other Heating Appliances KW Security Systems:* No.of Dryers No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters Signs KW Ballasts No.of Devices or Equivalent Telecommunications Wiring No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: /t2`.'n' `' (When required by municipal policy.) Work to Start:,/1 6. 2 0 6 2- Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: 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.c��) CHECK ONE: INSURANCE ❑ BOND ID OTHER ❑ (Specify:) // I certify,under the pains and enalti s of perjury,that the informati n 9n this application is true and complete. f�� j 9,T-y b`s, LIC.NO.: Z Z�54—.1— FIRM NAME: L�� d� - � �tP � J 42,1(9 J Signature LIC.NO.: /`r S s Licensee: 9�-��.�3 y (If applicable, enter "exempt"in the license number line.) Bus.Tel.No.:U Address: 2 G 4,C .>1lj/2 (0hOP /1,1, 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 Telephone No. I PERMIT FEE: $ Signature