HomeMy WebLinkAboutBLDE-23-006149 Barber Shop of �\ Commonwealth of Official Use Only 4�`° Massachusetts Permit No. BLDE-23-006149
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:5/7/2023
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) 1120 ROUTE 28
Owner or Tenant MITROKOSTAS NAFSIKA ELENI TR Telephone No.
Owner's Address S&N REALTY TRUST, PO BOX 260, SOUTH YARMOUTH, MA 02664
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: MNiscellane4ous work per attached. (BARBER SHOP)
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 8 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. 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 0 Municipal ❑ Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water 1 KW No.of No.of Ballasts Data Wiring:
Heaters Sins 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: Ruy Coelho Signature LIC.NO.: 56863
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 15 Nancy Lane, Hyannis MA 02601 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
4Signature Telephone No. PERMIT FEE: $260.00
CC44-1)1,( sic/2-5 rE
`a iii-24/1, _____
RECEwVFP ,
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- AY 0 3 2023C� ea .o/ir/adaact'ivaaifa Official Use Only
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B` `"'r Permit No. Z� — R
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�•" DING DEPARTM �''t"'�"fO �� J
Occupancy and Fee Checked
I'REVENTION REGULATIONS [Rev. 1/07] (leave blank)
::AAPPLICATION 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: .CS�,Q 3 •-"2 3
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) /! ? R Gc'7e c r _co`7i
Owner or Tenant ye,� ���"��'
A4 /t6 O,A-05 j'cz S ti°0 I71"C: . t-LNHi '77q Telephone No. ,'•4zf7°,S7.3 4, 6 v
Owner's Address S,1 /V /ec L 7 y rrec, $ f re a x 6 v
Is this permit in conjunction with a building permit? Yes ❑ No
biz Purpose of Building CO ill riot e E.c, L (Check Appropriate Box)
Utility Authorization No.
4,4 Existing Service 200 Amps //G / lie,Volts Overhead❑ Undgrd g No.of Meters ___I___,
New Service Amps /Number of Feeders and Ampacity Volts Overhead❑ Undgrd ❑
No.of Meters
(� (' Location and Nature of Proposed Electrical Work: 5-
Q) a,. .c- is/) gece5 S 41 4 .15 a Ic/,ti- er'it-
i - L. P4 L., X 1Kv�C'S
.1 �r t�t�c�jt� h/N'a�`F
tix� Completion of thefollowingtable may be waived by the In vector of Wires.
` _ tl' No.of Recessed Luminaires No. f
!. o o
1� 1 No.of Cell:Susp.(Paddle)FansTotal
Transformers KVA
V
( No.of Luminaire Outlets No.of Hot Tubs
Generators KVA
ftIN
No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting
.sir grnd. grnd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
, No.of Switches No.of Gas Burners No.ofbetection and
l i` No.of Ran es Initiating Devices
g No.of Mr Cond. Total
Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump1Number I I Tons KW 'No.of Serf-Contained
Totals:I j Detection/Alerting Devices
No.of Dishwashers
Space/Area Heating KW Local 0 Municipal
Connection 0
other
1 No.of Dryers Heating Appliances KW Security Systems:4
\� Ni No.of Water No.of No.of Devices or Equivalent
a No.of
Heaters ' Data Wiring:
Signs Ballasts No.of Devices or Equivalent
-� Z No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
OTHER: No.of Devices or Equivalent
�v
Attach additional detail if desired,or as required by the Inspector of Wires,
Estimated Value of Electrical Work: Alw Gar°`'�`'
O L� p (When required by municipal policy.)
Work to Start: 05
1 3/ 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
V 1 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:
LIC.NO.:
Liceaaee: Ur ___
e L Signature / ._
(/fapplicable,enter,elempt"in the license number line.) —�as�. LIC.NO.: �'E _�
Address: /5 N&vc CY S 1 4 c 1Ylei n s? t Bus.Tel.No.`Sc�3 fic>>
*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 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 a.ent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$