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Home My WebLink AboutBLDE-22-005430 LY Commonwealth of Official Use only _ , `} Massachusetts Permit No. BLDE-22-005430 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:3/29/2022 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) 49 DOHERTY LN Owner or Tenant James Telephone No. Owner's Address 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 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New residence. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 60 No.of Ceil:Susp.(Paddle)Fans 3 No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs 1 Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 70 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 35 No.of Gas Burners 1 No.of Detection and Initiating Devices No.of Ranges 1 No.of Air Cond. 2 Total 6 No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 4 Totals: Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: 4 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 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: PAUL DELIGIANIDIS Licensee: Paul Deligianidis Signature LIC.NO.: 22536 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:26 DUNEDIN RD,WELLESLEY MA 024815422 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 Gv i// epriar' / inst.Uet/7a -w. RECEIVED ; 2 5 2U22 mnwnwQa[th o� aaaachuaattd Official Use On y 'Al,-.;,;'>'l...a� ti c� �_ J (! . ! — ---.— starimant of ire Sirvutd Permit No. ��Z " S �` �/KvUiNC� I2F � l! PREVENTION REGULATIONS Occupancy and Fee Checked Rev. 1/07j leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRI A W p All work to be performed in accordance with the Massachusetts Electrical Code(ME ,527 C R~p r r O R K (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: Y p Date: 2 2- To the Inse tor of ires: By this application the undersigned gives n notice his or her to perform the electrical work describe Location(Street&Number) d below. Owner or'fit - E Owner's Address Telephone No. :t .j •- ,_C ~7_ 3-C 7 Is this permit in conjunction with a buildin Purpose of Building i g Permit. Yes No El (Check Appropriate Box) Utility Authorization No. Existing Service Amps P � Volts Overhead❑ Undgrd E No.of Meters Ne=Service E t Amps 2;; / L p Volts Overhead Number of Feeders and Ampacity ❑ Undgrd t❑� No.of Meters �_ Location and Nature of Proposed Electrical Work: vi fv• Completion o the ollowin: table m be waived b the Ins,ectoro {fires. 1i•' No.of Recessed Luminaires !'•� No.of Ceil:Susp.(Paddle)Fans 3 o.o ota `-ti No.of Luminaire Outlets Transformers V C.\ No.of Hot Tubs j KVA Generators KVA A•1' No.of Luminaires Swimming Pool ' 'ove rnd. ❑ °- 'o.o mergency g mg `` No.of Receptacle Outlets °d• 0 Batte Units :�. -7 c No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 7 No.of Gas Burners `o.o t etec on an• if' 1 No.of Ranges Initiatin, Devices I No.of Air Cond. 7.. ota No.of Waste Disposers Tons No.of Alerting Devices p i 'eat 'ump `um u er oils. kW `o.o e - onta ne• No.of Dishwashers Space/Area HeatingDetects.) /Alertin, Devices KW Local r un c pa ecur t No.of Dryers Heating Appliances Connection ❑ Other `o.o "a er KWy yystems: Heaters KW `o.o . No.of Devices or E I uivalent / o.o Data Wiring: Sins Ballasts No.Hydromassage Bathtubs No.of Devices or E•uivalent ! No.of Motors Total HP a ecommun ca ons " r ng: OTHER: No.of Devices or E.uivalent 2 S Attach additional detail ifdesired,or as required by the Inspector of R'ires. Estimated Value of }lectr' al Work: Work to Staff: --- (When required by municipal policy.) SURANCE C 2 Inspections to be requested in accordance with MEC Rule 10,and upon completion. E GE: 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE irr BOND I certify,under the pains and penalties ojpe❑ OTHER 0 (Specify:) FIRM NAME: rjury,lhal the information on this application is true and complete. Licensee: LIC.NO.: (If applicable,enter"exem "in the license numb r line,) Signature -� -. '_-' Address: LIC.NO.: *Per M.G.L.c. 147,s.57-61,security work requites Department,r ' 1< ,t_r Bus.Tel.No.` y7 OWNER'S INSURANCE WAIVER: Alt.Tel.No.: / c of Public afety"S"License: Lic.No. y Orewner/Agent g law. By my signature below,t hereby aaware hVeat tthis requirementhe Licensee s'I mot the(check one ve the liability insurance coverage normally Ownred Agent Signature owner / owner's a.ent. Telephone No. PERMIT FEE:$