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Home My WebLink AboutBLDE-22-002962 0 .. //` Commonwealth of Official Use Only �, Massachusetts Permit No. BLDE-22-002962 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:11/21/2021 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) 23 SALT MEADOW RD Owner or Tenant KORIAN PAUL P Telephone No. Owner's Address KORIAN ANN H, 23 SALT MEADOW RD,WEST YARMOUTH, MA 02673 ' ,, Is this permit in conjunction with a building permit? Yes 0 No 0 (CheckcApere Ate Box) r . Purpose of Building Utility Authorization No. ', ,-, i Existing Service Amps Volts Overhead 0 Undgrd 0 1 Itelkdeters , New Service Amps Volts Overhead 0 Undgrd 0 No.u(Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement pool Completion of the following table ma w )ie1 d-by the Itivector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers d f KVA No.of Luminaire Outlets No.of Hot Tubs Generators `i 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number , Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 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: Licensee: John Weiss Signature LIC.NO.: 22602 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:63 Uncle Bobs Wy, South Dennis Ma 02660 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $270.00 RECEIVED NOV 18'_2' 4Maaaw amils Official Use Only BL'ILDIiVG t5EPAI 4 SOViCe, Permit No. .P Z_- Z/( 2Z- gire By. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.I/07f (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK - ,.i All work to be performed in accordance with the Massachusetts Electrical Code EC),5 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: // /7 ZI 1 City or Town of: tR/`wtpa 771 To the I pecto of Wires: By this application the undersigned gives cifnAce hisor her intention to perform the electrical work described below. Location(Street&Number) 2,3 / /'4-I e?e! Owner or Tenant Q--,,�- / Telephone No. Owner's Address 2 3 cs a.L T Ps't e-(�'(/�l/ U Is this permit in conjunction with a building permit? Yes ElNo El (Check Appropriate Box) (` Purpose of Building Q!e_c Utility Authorization No. u Existing Service X Amps / Volts Overhead❑ Undgrd❑ No.of Meters wNew Service Amps / Volts Overhead❑ Undgrd❑� '-No./of Meters Number of Feeders and Ampacity L Location and Nature of Proposed Electrical Work: /eC ,)" /�yye'1 t e1 e/ ,.v, Completion of the followingtable mgbe waived by the inspector of Wires. vi No. f (� No.of Recessed Luminaires No.of Ce6.-Susp.(Paddle)Fans Transformers KVo A C1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting ▪ No.of Luminaires Swimming Pool and. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones T No.of Switches No.of Gas Burners No.of Detection and Z. Initiatinng Devices al 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 Po Totals: _......_........._...._--.................. Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Local❑Municipa Oiler, P Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNofDevices or Equivalent No.of Devices Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of lectri al Work: /era (When required by municipal policy.) Work to Start: / Z/ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE GE: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❑ OTHER❑ (Specify:) I ceralfy,under the pains and penalties ofperjary,that the Information on this application is true and complete. FIRM NAME: �/t i.✓e.$'S WC.NCO2 - Licensee: 0 c41✓1 L✓(i tS0 ' D S�atun O LIC.NO.: Of applicable,enter"es t"iv the license nip lien lin;,f /l / Bus.TeL No.6 OV I 5 Address: SAY a'�Uhe /<J Jdc*t n'S Alt.TeLNo.: *Per M.G.L.c.147,a.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 0 owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.