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HomeMy WebLinkAboutBLDE-23-002948 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-002948 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:11/29/2022 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) 15 BARNACLE RD Owner or Tenant NICK PAPAKYRIKOS 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 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Inspection for service to restore power. 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 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 No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Troy Hines Signature LTC.NO.: 56707 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 482 Prospect Street,Methuen MA 01844 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 EE: $50.00 I/4- ( yv (Na //m ? mil;L� if t s/`z2 l • RECEIVED R -(�(. / 9 NOV 29 2022 A� yy� / L - Commonwaa/h o/rrtmdachudeltd Official Use Only >I-x--car,"si;_ ecms// (/`1� Permit No. r/ /- .I`'t. er.— ararinsed of Jw Serviced 1i BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked -. [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-a a, Cityor Town of: �— YARMOUTH To the Inspector of Wires: By this application the undersigned gived notice of his or her intention perform the electrical work described below. , U Location(Street&Number) /S q / p /?GrnG(IQ t�QG 4 Owner or Tenant 'I/CI( f,^eA Kyrtkei Telephone s / P �6�-ex2-y /9 Owner's Address /S /3,rhac(p /ZeAd Is this permit In conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) c Purpose of Building Utility Authorization�,ET-- i+ Existing Service/b U Amps (Zr)/aUo Volts Overhead ElE]Undgrd No.of Meters Z New Service Amps / Volts Overhead❑ Undgrd\Zt g ❑ No.of MetersNumber of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ('7,0% a,,) 4,xfer,or Completion of the followinglople may be waived by the Inspector of Wires. tit No.of Recessed Luminaires No.of Cell-Snap.(Paddle)Fans N°'°f 7 oral Transformers KVA Ci No.of Luminaht Outlets No.of Hot Tubs Generators KVA 4: No.of Luminaires Swimmin Pool Above In- No.of Emergency Lighting g Ernd. ❑ grid. ❑ Battery Units _ No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones ri No.of Switches No.of Gas Burners 'No.of Detection and < Initiating Devices Ill No.of Ranges No.of Air Cond. Total No.of Alerting Devices No of Waste DisposersHat Pump Number,.Tons._KW _ No.of Self-Contained Toffs: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Munic P Local❑Connection ❑other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Aydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: / // No.of Devices or Equivalent _ OTHER: /n S..044/h (Yr)'lt)rV ein e/-eci,-,,I,( v-',e Attach additional detail if desired.or as required by the Inspector of Wires. Estimated Value of Electrical Work: S d Z).Q 0 (When required by municipal policy.) Work to Start://-30-.2 a 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 liabilityinsurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coy ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND El OTHER 0(Specify:) I certify,under the pains and penalties of pedury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: /,'Oi Signature <<==�%� LIC.NO.:5-6/a 7 (If applicable,''t exempt"in the lie a number(hie.) //// Bus.Tel.No:R Cl.. op.$)7-c-,Address: a? P,-afer'7SfYeef 1.07 1,42n /1 CJ/299/ Alt.TeL No.: °Per M.G.L.c.147,s.57 1,security work requires Department of Public Safety S"License: 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. 1 am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$