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Home My WebLink AboutBLDE-23-003676 #16 Commonwealth of official use only kMassachusetts Permit No. BLDE-23-003676 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) 116 MANOR PATH Owner or Tenant THOMAS DONALD R JR Telephone No. Owner's Address C/O 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 16) 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 Q bovend. ❑ g rnd. ❑ No of Emergency Lighting r Battery Units C�3 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones ' No.of Switches No.of Gas Burners No.of Detection and ' Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent KW No.of No.of Ballasts Data Wiring: Heaters Siens 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 S eci I certify,under the pains andpenalties o (Specify:) f 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 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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. I y I PERMIT FEE: $180.00 1 1 rq r6 I1 rrEIVED 5 2J2f° sad Maniac j..__;'` ;,i IAN ��r/ �iuealla Official use only ,.ii,..p n';4v "t°� -�• Permit No. �v _ F p fjQ irs Serviced __ gg _� '' tyI— --6'WF k) '!�;` EVeNTiON REGULATIONS ROccupancy and Fee Checked leave blank a APPLICATION FOR PERMIT TO PERFORM ELECTRICAL All work to be perfonned in accordance with the Massachusetts Electrical Code(MEC),52,7jC1 RAL WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION') City or Town of: YARMOUTH Date: By this application the undersigned gvYARMhOUTHintention to perform the elect ical ector�kdes Wires: below. Location(Street&Number) gives / /14N0e 104Ty ow. %. Owner or Tenant 4 4 6't: Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yea E No Purpose of Building � /�� ❑ (Check Appropriate Box)_ Existing Service ?OiC Amps Utility Authorization No. p /?tom /Z d Volts Overhead Er Undgrd New Service g 0 No.of Meters Z Amps / Volts Overhead 0 rd Und Number of Feeders and Ampacity g 0 No.of Meters % Location and Nature of Proposed Electrical Work: Com.letion o the allowin•table m be waived b the Ins i ector lie No.of Recessed Luminaires o Wires. ./ No.of Ceii.-Snsp.(Paddle)Fans o.o ota No.of Luminatre Outlets Transformers KVA .. No.of Hot Tubs Generators KVA ,�t':. No.of Luminaires l ove n- 'o,o mergency g in Swimming Pool ,rnd. [] �f No.of Receptacle Outlets " . ❑ Batte Units g .,F No.of Oil Burners FIRE ALARMS No.of Zones • z No.of Switches No.of Gas Burners 'o•o t etec on an i�! No.of Ranges Initiatin. Devices No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers 'eat 'ump `um er ors ' ►s Totals: ...._...,_....__..... o.o e onta ne• Detection/Alertin No.of Dishwashers Devices Space/Area Heating KW Local❑ `un c pa No.of Dryers Heating Appliances KW ecur ty Connect stems: ❑ er `o.o "a er .o o No.of Devices or E•uivalent Heaters ' o.o Data Wiring: Sins Ballasts No,of Devices or E•uivalent No.Hydromassage Bathtubs No.of Motors Total HP mun No.of De a ecomfDe ca ors " r g: vices or E•uivalent OTHER: Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work to Start: �,(�E'�// p (When required by municipal policy.) 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 linV BOND 0 OTHER I rectify,under the pains and penalties o 0 (Specify:) FIRM NAME: fper,�ury,that the information on this application is true and complete. Licensee: a/UI Oi�rg�� L__��_ LIC.NO.:_��/ (If applicable,enter"exem t' m esercqnse numb line.) Signature Address: 91 �"�ljC LIC.NO.: /Q Q ,d► *Per M.G.L.c. 147,s.57-61,security work requires Department of To ubl c Safety Fr G` Bus.Tel.N0.• /eryl OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurancl.e covers a normally "S"License: Lic,No. requie law, By my signature below,I hereby waive this requirement. I am the(check one • owner Owner/Agentdby lag rurally Signature � owner's a:ent. Telephone No. PERMIT FEE:$