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Home My WebLink AboutBLDE-23-001258 _ Commonwealth of 0Official Use Only Massachusetts Permit No. BLDE-23-001258 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:9/9/2022 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) 44 CLOVER RD Owner or Tenant JOHNSON KATHRYN J Telephone No. Owner's Address TWOMBLY WAYNE A, 8 OTTER LN, GROTON, MA 01450 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. ( l 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 fT Location and Nature of Proposed Electrical Work: Remodel bathroom. 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 'I{yA 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 Initiatine Devices No.of Ranges No.of Air Cond. Ton l Nu.of Alerting Devices 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 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 ❑ (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.: 20442 (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: $75.00 Commonwealth o`Maotachatette "�Officicial Use Onlyl ` k.47171 c7 [� Permit No. f3-3 A ! €) `rd �)epartment o`Jire Seroicee Ali tl Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) 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: .9/i/11 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. Qt Location(Street&Number) 4// C LO vE,e ,e,Q Owner or Tenant r70%'Nson/ , 97//°yam/ Telephone No. Owner's Address V),/cc Er Is this permit in conjunction with a building permit? Yes 1Q No ❑ (Check Appropriate Box) Purpose of Building ,PWC(/..IJ_C Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd El No.of Meters V New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty aLocation and Nature of Proposed Electrical Work: /'/)7#/, 'CCU PE','Q qe-e/,' b Vol Completion of the jollowinEtable m be waived by the Inspector of[Mires. th No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans No.off 7 otal 0/ Transformers KVA '1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA k.. No.of Luminaires Swimmingpool Above in- No.of Emergency Lighting grnd. ❑ &t'nd. ❑ 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 i t' No.of Ranges No.of Air Cond. Tons! No.of Alerting Devices No.of Waste DisposersHeat Pump Number..Tons_..,KW 'No.of Self-Contained Totals: --. ...... Detection/Alertin�Devices No.of Dishwashers Space/Area Heating KW Local❑Municipal ❑ �, — Cyonnection _ No.of Dryers Heating Appliances KW Security No. f Devices or Equivalent No.of Water , Na.of No.of Data Wiring: Heaters 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: /,QEI t 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0(Specify:) I certify,under the pains and penalties of perjury,that the information on this a lication is true and complete. FIRM NAME:,72/ /tJC CLI.9/✓/C/9 e (C l/7" '9C fO,J LIC.NO.: 20 9 cee)A Licensee: G!//d! �//7/N4j�t Signature L s LIC.NO.:/�'/`J4/Ot 6 (Ifapplicabl "exempt"in the lice number line.) Bus.Tel.No.�-S�09 '. /,/ Address: l,/U/CPLt I Gf/At /1MI.r`'JratiJ /At/G ex Alt.Tel.No.: '''Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: i am aware that the Licensee does trot have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$