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HomeMy WebLinkAboutBLDE-23-005058 Commonwealth of Official Use Only # ,fr Massachusetts Permit No. BLDE-23-005058 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked f Rev.l/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:3/15/2023 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) 1050 ROUTE 28 Owner or Tenant ZOGRAFOS GEORGE D TRS Telephone No. Owner's Address ZOGRAFOS CATHY LEE TRS,45 TORREY RD,EAST SANDWICH,MA 02537 Is this permit in conjunction with a building permit? Yes❑ 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: Miscellaneous work&renovations to building.(DUNKIN DONUTS) Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 5 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires 30 Swimming Pool Above ❑ I n- ❑ No.of Emergency Lighting grad. grad. Batters'Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 3 No.of Gas Burners No.of Detection and Inttiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons LW 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 KW No.of No.of Ballasts Data Wiring: Heaters Sinus No.of Devices or Etuivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: 8 No.of Devices or Eauivalent 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:) 6 17-SqZ-50 n I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Joseph L Moniz Licensee: Joseph L Moniz Signature LIC.NO.: 14635 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:33 FRANKLIN ST,SOMERVILLE MA 021453236 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 ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$200.00 4I41 (CtiL-Tt-.AL e4RLEI CEtc.tnrc 644 CFI IV L `clzo(73 ,e- - Commonwealth of Massachusetts Official Use Onl Permit No.: —:4�- Department of Fire Services Occupancy and Fee Checked: `16— 4 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023] ��,....,'' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 CMR 12.00 City or Town of: YARMOUTH Date: 3 /y--2. To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electrical work described below. Location(Street&Number): /DSO 1 '% g- Lf4/7/170 f31w Unit No.: Owner or Tenant: /7v/U+C/A.l (j / j7 S Email: Owner's Address: /(o'' /nr}tt) S? ,St/V2/l, i /1 Phone No.: Is this permit in conjunction with a building permit?(Check appropriate box)Yes l No❑ Permit No.: Purpose of Building: <c 7..41aL Utility Authorization No.: Existing Service: z-/00 Amps /20 /air Volts Overhead❑ Underground© No. of Meters: New Service: Amps / Volts Overhead El Underground El No.of Meters: Description of Proposed Electrical Installation: >CiC1$Tii j pc,,,, L, ,riS, ITS k1 e Agv..c ciiir ' glocvre ov) €-Z -,,4// AJeiu t°m'4 p, ,e'(cnirs e / /vi4.e-ie-S r , -7/f- . Completion of the following table may be waived by the Inspector of Wires. 4JI F ain r C'ou'f7,e'Z No.of Receptable Outlets: i No.of Switches: _3 Generator KW Rating: Type: No.Luminaires: 3 0 No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating: No.Appliances: KW: No. Water Heaters: KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: No.Heat Pumps: Total KW: Total Tons: Fire Alarm System 0 No.of Devices: Swimming Pool:In-Grnd.❑ Above-Grnd.❑ Hot-Tub❑ No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices: No.Air Conditioners: Total Tons: Telecom System B No.of Outlets: $ No.Energy Storage Systems: KWH Storage Rating: Security System ❑ No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: No.of Modules: Roof-Mount 0 Ground-Mount 0 Level 1 ❑ Level 2❑ Level 3 ❑ Rating: OTHER: Attach additional detail if desired, or as required!"the Inspector of Wires. Estimated Value of Electrical Work: e75,n6'i (When required by municipal policy) Date Work to Start:,b Li-/3-2 Inspections to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: ,il Ct 11,' FhEe Ztii C A-1 0 or C-1 ❑ LIC.No.: A l-3 2 27 Master/Systems Licensee: JSepi4 /f7/71 7_ LIC. No.: /1-11410 3,j Journeyman Licensee: Jep/d-/)i00 t z_ LIC.No.: L`-S3,Z; 0/ Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: Address: -3 / i j]ti l A/ 51-- Sc.-wit/42L 2/LC fti/4 &2/44 Email: () (a' /270/li 7 , /5(2:712it ,al Telephone No.: 6//— —SZr 7 j I certify,under he pains an1dpenalties of perjury,that the information on this application is true and complete. Licensee: .�) ,%►�(91UJ3 Print Name: MS641./110/11 L Cell.No.: 0 l7— 2 Z7 79 INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability 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❑ OTHER❑ Specify: 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: Tel.No.: Signature: Email.: