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Home My WebLink AboutBLDE-23-003675 #14 ' 'V Commonwealth of Official Use Only te_, Massachusetts Permit No. BLDE-23-003675 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:1/6/2023 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) 14 We MANOR PATH Owner or Tenant THOMAS DONALD R JR Telephone No. Owner's Address CIO JENNIFER THOMAS, 87 COOLIDGE 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: Rewire dwelling(UNIT 14) 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 4 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 ill No. Initiating Devices tt� 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No. romassa H d a Bathtubs No.of Motors Total HP Telecommunications Wiring: y g 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: $180.00 1 l Cat i I t{2-; ram,... (q 11 .- I c6/z3 V 0 RECEIVE [ Vo \moLiañh.0/7addachudattd Official Use Only z '''''' 49aIANQ5M c7 . ' (7 - /s Z n1 of Jiro sQrvicsd Permit No, -' 'e ILuten rF T EVENTION REGULATIONSOccupancy and Fee Checked v �'•.:':2 _ [Rev. 1/0?) (leave blank) \ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 0 All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 \ (PLEASE PRINT.TN INK OR TYPE ALL INFORMATION) Date: City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersign uses notice of his or her intention to perform the electrical work described below. Location(Street&Number) ✓I� , /f.4A(/O,e /047,/ Owner or Tenant C )-Q6'C Telephone No. i Owner's Address Is this permit in conjunction with a building permit? Yes V No ❑ (Check Appropriate Box) Purpose of Building ,e9/i!4--L//9/C' Utility Authorization No. \ 'NibExisting Service Poe Amps ma ?ea Volts Overhead ref Undgrd❑ No.of Meters Z VNew Service Amps / Volts Overhead❑ Undgrd ElNo.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ,f f'1 1/ 'C AAve 4/4/4, 5' VI 0 Completion of the followink fable muy be waived by the Inspector of Wires. ti No.of Recessed Luminaires No.of Cell:Sus No.of Total ,/ p.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA 4 No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grnd. grnd. ❑ Battery Units ;l No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS jNo.of Zones N� No.of Switches No.of Gas Burners 'No.of Detection and 1 — Initiating Devices ' No.of Ranges No.of Air Cond. T nsl t No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons 1 KW 'No.of Self-Contained Totals:I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.ofNo.of D No.of Water evices or Equivalent Heaters ' N0 of Data Wiring: 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: (When required by municipal policy.) Work to Start: ,eee'S E4(/7' 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 cover ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this appticatiorr is true and complete. FIRM NAME: f,O /�YECy,¢�/C,4 C O4/7e4C raef Z e C LIC.NO.: fG,,,f'.o/ Licensee: cyceJUf 14-7/#0�4 f Signature dr (If applicable,enter"exem t"in( license number line.) LIC.NO.: /� Q Address: 5 ' C'L/UCeettS Gv4 y ,7• f 7044 .#4,/Gl f. Bus.Tel.No.• O Age TelNo.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic..No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does trot have the liability insurance coverage normally required by law. Ry my signature below,I hereby waive this requirement. I am the(check one)Owner/Agent t ❑owner ❑owner's agent. Signature Telephone No. I PERMIT FEE:$ I 47i gilQ_,,.)i