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Home My WebLink AboutBLDE-23-003892 N._-- Commonwealth of Official Use Only �E. ,�) Massachusetts Permit No. BLDE-23-003892 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:1/18/2023 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) 279 OLD MAIN ST Owner or Tenant ACHESON ELEANOR D Telephone No. Owner's Address HEWITT EMILY C,425 8TH ST NW#1129,WASHINGTON,DC 20004 Is this permit in conjunction with a building permit? Yes ❑ 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 Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for addition. 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- CINo.of Emergency Lighting grad. grad. 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 _Imtiatine Devices No.of Ranges No.of Air Cond. Ton 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 ❑ 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 Siens 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. nr--� CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) 8-(?4-b(r8 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.: 10408 (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:$75.00 Qua 1)2).43 r . • Kot, S/(4l23 0 v ; RFCEIVEDI JAN 17 202 ornmonsvoauh oi Maddachu.letto Official Use O ly 5iit1'ra;- .. 2! i c�- S Permit No. L -:!'.--.I DING DE PA R! .4 a�lrrunf o/ ire arvicad 11'7, ----- _ Occupancy and Fee Checked =• ' E • • REVENTION REGULATIONS Rktfaiev. 1/07) leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 if (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1 f/7/? 3 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) 2 79 pe z, / ,//tf 5 7 Owner or Tenant 4(L/C,$ z e/9A/0,e Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes �' No El (Check Appropriate Box) Purpose of Building �El//l/(' Utility Authorization No. \1Y Existing Service Amps / Volts Overhead Undgrd No.of Meters ` Service 1 New Amps / Volts Overhead n Undgrd ❑ No.of Meters Number of Feeders and Ampacity / / • Location and Nature of Proposed Electrical Work: wl,Q.� a0/e) /f/CAi 1 0, ryCompletion of thehefollowin table a be waived by the Inspector of Wires. l!t No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans To.off 'total (-4 Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA t No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting _grad. gr 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 iI! No.of Ranges No.of Air Cond. Tons No.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 ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.KW No.of No.of Data Wiring: Signs Ballasts g 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: (ferS f/1/f 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,rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:) I certify,under thi�eff a ains and penalties of perjury,that the Information on this application is true and complete. FIRM NAME: ./ Mt-C /, /V/C.4C C OA'7'"47C r4ef L eC LIC.NO.: Op O9 4/ Licensee: (e�/(/I �/�/tnj/N i Signature c7� LIC.NO.: /C' 'O/4S (If applicab ent}r"exempt"in the l,�e number line.) Bus.Tel.No.. SO///7.4 0//,' Address: 9f CH(/C,f�L E ( t t9 /Yi )7rofrf /1/LLf "Mt Alt.Tel.No.: *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lie.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 agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ `7C---- • ci6-4,k ( 3 lows lAi