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Home My WebLink AboutBLDE-22-003910 07 �, Commonwealth of Official Use Only �'_ `` Massachusetts Permit No. BLDE-22-003910 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:1/13/2022 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) 175 ROUTE 28 Owner or Tenant ZAMBELIS EVANGELIA K TR Telephone No. Owner's Address THE TASTY TIDBITS RLTY TRUST, 335 ROUTE 28,WEST YARMOUTH, MA 02673 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 Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Mete Number of Feeders and Ampacity //7/ Location and Nature of Proposed Electrical Work: Remove section of bar& install new lighting. �///, 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. 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 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 Eauivalent 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: Rex A Burger Licensee: Rex A Burger Signature LIC.NO.: 17037 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:2045 MAIN ST, MARSTONS MLS MA 026481864 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: $80.00 t? 1L i 11a (-)/v, • • Li \� commonwealth of Ma6dachud¢(fd • Official Use Only s� ` oi. Y " - �-: c'�, Permit No. �—3 "6 c Q cv _ =__11 _ ..Ucparfinerf o/5irc serviced • '' -' Occupancy and Fee Checked =-_,yamr.- BOARD OF FIRE PREVENTION REGULATIONS {Rev- 1/07]CD eave blank) ADDIIr/tirrn►1V (�/� �/�/[O <__ rmrvKm tLl: I KIUAL ■PORK � _�m T All work to be performed in accordance with the Massachusetts EIectrical Code(MEC),527 CMR 12.00 SE PRINT IN INK OR TYPE ALL 1NFOR_AilATION) Date: 1113.420 a City or Town of: YARM\ZOUTH To the Inspector of Wires: By this application the Etndersig ied gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) 175 P-i-, D$ W- yl, wlo ,,4Owner or Tenant ID; Par hiA. -1f a(t ;/ ( G i (Y Telephone No.5-651 7 7/-77 7 Owner's Address G Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Re s f a v ra„ F Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd ❑ No. of Meters New Service Amps / Volts Overhead❑ Undgrd g ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �,1.1 s 5e�l b,,s O it a a461 Im sf+i( ne_w ( (SG{t�S �l 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. ❑ gird. ❑ 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 Total , No.of Ranges No of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump j Number Tons H KW No.of Self-Contained Totals: I Detection/Alertina Devices No.of Dishwashers Space/Area Heating KW Local Q Municipal Connection ❑ 7 No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No. of Heaters KW No. of Data Wiring: 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 8 0 6 • t)c) (When required by municipal policy.) Work to Start: gic/dOol Inspections to be requested in accordance with MEC Rule 10,and upon completion. , INSURANCEVERAGE: 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 []r BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Rex. 8tcor g(o ►.ic LIC.NO.:4 Licensee: Peg 13c.vi4---- Signature �� 4-22 LIC.NO.: (If applicable, enter "exempt"inthe license number line.) Bus.Tel.No ?! r— , Address: 2645 , 4A 5 Mat,iturr Mt /lc ,! 'Per M.G.L. c. 147, s.57-61,security work requires Department of Public SafetyAtt.Tel.No.: eP "S"License: Lic. No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/Agent I Signature Telephone No. I PERMIT FEE: S.