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Home My WebLink AboutBLDE-22-003128 • ,,, Commonwealth of Official Use Only A Massachusetts Permit No. BLDE-22-003128 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:12/1/2021 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) 121 SILVER LEAF LN Owner or Tenant AGELOPOULOS JAMES L LIFE ESTATE Telephone • O Owner's Address AGELOPOULOS DEAN J, 1058 ALBEMARLE RD, NORWOOD, MA 02062 Is this permit in conjunction with a building permit? Yes 0 No 0 (Che 1 N:o Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 rs New Service Amps Volts Overhead 0 Undgrd 0 No.of M Number of Feeders and Ampacity a Location and Nature of Proposed Electrical Work: Wiring for two HVAC systems. Completion of the following table may a' ed es'ector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of otal Transformers V25 KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 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 2 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 2 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 Connection 0 Other: 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: 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: $50.00 ')NA 141421 lee. ei .te,O044) ., Rr7cr - i r _ --- /� y�t —q, ,( e nonwaa(th a/rrlassarhto4r/fa Official Use Only J 3 i � )2021 �22-3i�—F5 k:r-V rr�� ''/t Serviced Permit No. i � 1.IrPartmanl o`Jiro Jiruicrr I^ I Occupancy and Fee Checked t BOARD OF FIRE PREVENTION REGULATIONS (Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical CodfgylEC1,527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION( Date: I!J o/aO a I 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)/a / SI/L.e-e.I eti-F- /..a n 4-- Owner or Tenant -ja lM Lt A 5 e'n I O u 1 O.5 Telephone No. Owner's Address S cs Ai t, Isthis permit In conjunction with a building permit? Yes ❑ No y Er (Check Appropriate Box) Purpose of Building Utility Authorization No. iExisting Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters 1 New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: EA)I r t- 7- y\e_.---, A_c_ t. in,•]`S a rrf 2- Air hanJiev/fvrv)ctceS Completion of the followirrgfable may be waived by tire In vector of{Fires. No.of l4• No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers TKVA ='a No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. grnd. Battery Units No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Taos No.of Alerting Devices No.of Waste Disposers Beat Pump Number Tons KW No.of Self-Contained Totals: . . ..._ .__ Detection/Alertin Devices - No.of Dishwashers Space/Area Heating KW Local❑Muc nnine ipctional 0 Other _ Co No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: - Anach additional detail if desired or as required by the Inspector of(Fires. Estimated Value of Electrical Work: 3t 0)0 (When required by municipal policy.) Work to Start: 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Er BOND 0 OTHER 0 (Specify:) I certify,under th�ains d penalties of perjury,that the information on this application is true and complete. FIRM NAME: F'x•R H()rsaw F—/et -r/earl LIC.NO.:A/7037 Licensee: PPee_ II,y5,y,. Signature LIC.NO.: (If applicable.enter"exempt"in the license number line.) Bus.Tel.No.•d ? 3 J} 4 Tp� Address:a 0,4 r m..4 C{ yta,c1a,. AAt t( -44,4- Alt.Tel.No.: "Per M.G.L.c.147,s.57-61,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. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$