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Home My WebLink AboutBLDE-22-005730 Commonwealth of Official Use Only ' r Permit No. BLDE-22-005730 Massachusetts 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:4/7/2022 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. f" Location(Street&Number) 1341 ROUTE 28 Owner or Tenant PANAGIOTU MATTHEW W TR Telephone No. Owner's Address ZOITSA PANAGIOTOU TRUST,25 TERRACE DR,WORCESTER, MA 01609-1415 Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Me er New Service Amps Volts Overhead 0 Undgrd 0 No.of Number of Feeders and Ampacity (i) Location and Nature of Proposed Electrical Work: Remodel Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 24 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 4 grnd. grnd. Battery Units No.of Receptacle Outlets 8 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 8 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total 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 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water K\V No.of No.of Ballasts Data Wiring: 3 Heaters Siens No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: 3 No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. I 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: JOHN C BURKE Licensee: John C Burke Signature LIC.NO.: 50364 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:45 DIX ROAD EXT,WOBURN MA 018016104 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: $100.00 RECEIVED :1. [APR 0 6 20kL�� .a/.t al Official Use Only t _Ct __. .. l.a Lfh nj C'�/7 11 L DI NG DE PA RTpNia d oc7 ca.rv�fd Permit No, 2—`7 /3,9 I I � — f J J Occupancy and Fee Checked / BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] �/ \fkto_ (leave blank) ( ? APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK �J All work lobe performed in accordance with the Massachusetts Electrical Code(MEC)527 C R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /�(, a City or Town of: YARMOUTH To the Insp`ttor o ires: U By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) /3 t"/ /724 - R Owner or Tenant pf—s 0 / pt„.,,r.v L Z. 0 Telephone No..SV Sr— Owner's Address jG/ Is this permit in conjunction with a building permit? Yes W No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters JNew Service Amps / Volts Overhead O Undgrd❑ No.of Meters ,� Number of Feeders and Ampacity �) Location and Nature of Proposed Electrical Work: Reno ILA I ,u Completion of the followingtable my be waived by the Inspector of Wires. 0, Na.of Recessed Luminaires /� No.of Ceil:Sas No.of Total p.(Paddle)Fans / Transformers KVA Zl No.of Luminaire Outlets No.of Hot Tubs Generators KVA -i No.of Luminaires Swimming Pool Above ri❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units iat V No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS !No.of Zones No.of Switches a No.of Gas Burners -No.of Detection and Initiating Devices No.of Ranges l No.of Mr Cond. Toni No.of Alerting Devices No.of Waste Disposers i Heat Pump I Number Tons IKW No.of Self-Contained Totals: ��-�, Detection/Alerting Devices No.of Dishwashers .— Space/Area Heating KW Local❑Municipal Connection ❑Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Heaters KW Signs Ballasts Data Wiring: of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent 3 OTHER: C/i Attach additional detail if desired,or as required by the Inspector of Wires, Estimated Value of ec cal Work. ()00. (When required by municipal policy.) Work to Start: S Inspccti2ns to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE V G : 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 BOND 0 OTHER 0 (Specify:) I certify,under the pains and enahies of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: �O 4Af 607t e Signatu LIC.NO.: (If pp/icable,enter"exempt"i the license number line.) /�- 5 O /L/ Address: - /✓a Bus.TeL No.• Per M.G.L.c.147,s.57-61,security work requires Department of Pu c Safety"S"License: Alt Lic.No.el.No.• /_7�� / `�OWNER'S INSURANCE WAIVER: I ant 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 ant. Owner/Agent Signature Telephone No. PERMIT FEE:$ 1 tStii :4