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Home My WebLink AboutBLDE-23-000598 Commonwealth of Official Use Only lr Massachusetts Permit No. BLDE-23-000598 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.1/07j 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:8/4/2022 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) 66 HOMERS DOCK RD Owner or Tenant GLODIS PATRICIA A Telephone No. Owner's Address 66 HOMERS DOCK RD,YARMOUTH PORT,MA 02675 Is this permit in conjunction with a building permit? Yes 0 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 ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Hot tub&grill area. 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 1 Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 2 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 Ions 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 ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total Ill' Telecommunications Wiring: 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LONGFELLOW DESIGN BUILD Licensee: Jeromme Marques (ot (Q I_ Signature LIC.NO.: 22751 (If applicable,enter"exempt"in the license number line 4,5 37 Bus.Tel.No.: Address:26 Lake Avenue,Wobum MA 01801 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:$200.00 getOtA) A r qhf c- RECEIVED AUG042012 I a� ` J ..-. �o aa[th of Massachaaatla Official Use Only t''1 t3INGDEPARTMr 2 C� ., ....,."', — _ Permit No, �i2J �� E l_ Occupancy and Fee Checked ^. ' :` BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) ` APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK t All work to be performed in accordance with the Massachusetts Electrical (MEC),527 CMR 12.00 t (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 'I Li/2 o - ?- N. City or Town of: YARMOUTH To the Inspector of Wires: . By this application the undersigned gives notice ofhis or her intention t perform pe electrical work described below. • Location(Street&Number)6.G y p,A 6X S ,b 0 c-x- I Owner or Tenant / V/Gr,f GlOch S Telephone No. To dJ y.79 s Z c-- � Owner's Address • \,[ Is this permit In conjunction with a building permit? Yes ❑ No Ll (Check Appropriate Box) e. Purpose of Building 5/v„9,/,; �itrc/ /y Utility Authorization No. Existing Service Z c 0 Amps (L O1 2.'1°Volts Overhead[9 Undgrd❑ No.of Meters ' cZY New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters *" Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: it/pT f(/4 c .,e //,t/- 0c / Completion of the following table meg be waived by the Inspector of Wires. u� No.of Recessed Luminaires No.of Cell.-Soap.(Paddle)Fans No.o Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs , Generators KVA -4. No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting �tnd. grnd. Battery Units �t No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones - n, No.of Switches No.of Gas Burners -No.of Detection and c Initiating Devices l l• No.of Ranges No.of Air Cond. To sl No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons RW 'No.of Self-Contained Totals: " .. Detection/Alertiu Devices No.of Dishwashers Space/Area Heating KW Local 0 Mounicip 0 Other Cyyss m nnection No.of Dryers Heating Appliances KW SecNo uriof Devices or Equivalent No.of Water Heaters KW No.of 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: ?co O• ,'' --' (When required by municipal policy.) Work to Start:ty e 02 'L Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE0 RAGE: 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 certify,under 4e pains and penalties of perjury,that the infornmtlon on this application is true and complete. FIRM NAME: R3,✓/et,th 4- it A. ("to (ti G ' LIC.NO.:22 1 SA,1 Licensee: 1t- ?Ott//, 't- �/tPaJc71 Signature ,� LIC.NO.: (If applicable enter"exempt"In the license number 1 ) Bus.Tel.No.:6/1-sd/ 6 f 1-1' Address: 1 G e-44/ f_ .it v/7 (,t/O j c.",--- /vt.r OJ1 O / 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ to (, ` (u. LA / J w-41,1. �n