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Home My WebLink AboutBLDE-23-000734 - Commonwealth of Official Use Only 11„ Massachusetts Permit No. BLDE-23-000734 . 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:8/12/2022 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 1 logy. 0 m Location(Street&Number) 67 TAFT RD /kk�s�?�? GU0� Owner or Tenant ROBERT BUSHWAY Telephone No. Owner's Address 67 TAFT RD,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 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: Remodel kitchen Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 1 No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 1 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 7 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 4 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges 1 No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers 1 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: Licensee: Lazar Mitev Signature LIC.NO.: 56442 (If applicable,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: 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: $75.00 1U Ijce:_t.,i- ‘::((5(z/Vtg-, -ri jv --(( t,) ) i/Cf 3 (viii,,,24;01-ezta alict, i t J.5 O ik) ill -onel-i) . . PECEIVED1 1iLen_ c�7'] � c 1 1 2�2 ww•a[th o j Ma.machu att6 Official Use Only •, Permit No.ez3 -6 ? 1 : _ • rimed o f. `ire-cswicss - !; 'DING DEPARTMENT Occupancy and Fee Checked Ar 'h ', PREVENTION REGULATIONS Rev. 1/07j leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK a All work to be performed in accordance with the Massachusetts Electrical Code(MEC ,527 CMR 12.00 ZZ (PLEASE PRINT IN INK OR TYPALL INFOR 4TION) Date: 0,3*ZC, City or Town of: r a iP-teilit4 To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Q.) Location(Street&Number) 6" 4d'6 y ! Owner or Tenant li 6 e(4-,C7 ROber-I-- ; jASAY Telephone No. L. Owner's Address Is this permit in conjunction with a building permit? Yes E No E (Check Appropriate Box) SPurpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead n 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: //1` r J/L(1 �a,i-ee t cj'/ t, Nrt Completion of the following table mco'be waived by the Inspector of Wires. vt No.of Total No.of Recessed Luminaires /( No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets 4 No.of Hot Tubs Generators KVA c d No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lrghtmg grnd. grad. Battery Units No.of Receptacle Outlets .1- No.of Oil Burners FIRE ALARMS No.of Zones t No.of Switches No.of Gas Burners No.of Detection and Initiating Devices 1. No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers I, Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of DryersHeating Appliances KW Security Systems:* No.of bevies or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNo.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: 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 ❑ (Specify:) I certrfy,under the pains and penal'es of peryi,tf ry,that� the information on this application is true and complete. I `l� FIRM NAME: e'( Cal 3e/ '_.5L �;�,��-- LIC.NO.: L,°3�� Licensee: / ^� ! Signature LIC.NO.: r7 .4/2-irtf (If applicable,ent14- in the license number rne.) Bus.Tel.No.: Address: //30,e, .j2 f`I i Ili/ YVf it 026 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Dep.rtment 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 PERMIT FEE: $ Signature Telephone No.