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Home My WebLink AboutBLDE-19-001101 or Commonwealth of Official Use Only `` n% Massachusetts Permit No. BLDE-19-001101 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.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:8/22/2018 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) 12 DOHERTY LN Owner or Tenant RACHLIS VAL TRS Telephone No. Owner's Address RACHLIS ANITA TRS, 168 OLD FOREST HILL RD,TORONTO,ON MEC 2G8 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 ❑ 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: Security&fire system installation. 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- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 1 No.of Switches No.of Gas Burners No.of Detection and 5 Initiating Devices No.of Ranges No.of Air Cond. 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 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:`' No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: 1 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: Robert K Boucher Licensee: Robert K Boucher Signature LIC.NO.: 1317 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:218 SETUCKET RD,YARMOUTH PORT MA 026752258 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 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:$45.00 it-e-t1/4-kri—DV_ -- C icreoe �s 4 (As 14 \Commonwealth of Massachusetts OfficialUseOnly,` /� " 'q ' t Permit No. a�1— \(S1 I - olln-; Department of Fire Services 11� Occupancy and Fee Checked ., I BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (leave blank) �� y APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK r` All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 tVV` (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 8/21/18 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) 12 Doherty Lane,West Yarmouth Owner or Tenant Luke-Residence 4es p el! d,.-,'/nle-r Telephone No. Owner's Address Same Is this permit in conjunction with a building permit? Yes X No (Check Appropriate Box) 'el Purpose of Building Utility Authorization No. 1 _ Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters �"� New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Numlier of Feeders and Ampacity Q Locat.on and Nature of Proposed Electrical Work: Security and fire alarm in house under renovation. l> (� '> I Completion ojthe jo!/owing table may be waived by the huT calor ojWires. 1i1 cg N$.or Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA C,.).h5 � = N6.o[Luminaire Outlets No.of Hot Tubs Generators KVA IAA.) No.of Luminaires Swimming Pool Above ❑ In- 0 No.of Emergency Lighting , two �—. grnd. grnd. Battery Units — No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 1 No.of Switches No.of Gas Burners No.of Detection and 5 Initiating Devices No.of Ranges No.of Air Cond. Total No.o f AlertingDevices 5 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 ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of WaterK`,i, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: 1 No.of Devices or Equivalent OTHER: Attach additional detail ifdesire4 or as required by the Inspector of Wires. Estimated Value of Electrical Work: 2k (When required by municipal policy.) Work to Start: 8/20/18 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 X BOND 0 OTHER 0 (Specify:) I cert,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Seaside Alarms inc, / - IC.NO.: 1317C Licensee: Robert K.Boucher Signature 6��/` .„ LIC.NO.: (If /eapplicable,enter "exempt"in the license number line.) Bus.Tel.No.. 508-394-0599 Address: 1265 Route 28,South Yarmouth,MA 02664 Alt.Tel.No.: *Security System Contractor License required for this work;if applicable,enter the license number here: S-0046 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)0 owner ❑owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. t / . ? 'a � ) Irl N�-::/JJ f 4 l c. 1265 Route 28 • South Yarmouth, MA 02664 • 508.394-0599 • MA LIC. #1317C 24 HOUR PROTECTION August 24,2018 Ken Elliott Yarmouth Electrical inspector 1146 Route 28 South Yarmouth MA 02664 Re:Permit-BLDE-19-001101 12 Doherty Lane, West Yarmouth, MA Dear Inspector, Please cancel the electrical permit for 12 Doherty Lane,West Yarmouth. There was a typo on the permit application. The correct address is 19 Doherty lane, West Yarmouth.A corrected application is being submitted. Sorry for the inconvenience. Sincerely, 2r P ul Haygood Seaside Alarms Inc. Town of Yarmouth 0LfReceipt No.: 39050 1148 Route 28 South Yarmouth,MA02664 Receipt Date: 08222018 508.398.2231 RECEIPT RECORD&PAYER I11FORM4DON Record ID: BLDE•14001101 Record Type: Residential EbcMcal Property Address 12 DOHERTY LN,WEST YARMOUTH,MA 02673 Description c1 Work Security A fire system Mstallatbn. Payer. Applicant Robed KBoucher Robert K Boucher 218 SETUCKET RD YARMOUTH PORT,MA 028752258 PAYMENT DETAIL Data ',torment Method Reference Cashier Connote Amount 08/22/2018 Check 3482 KEUJOTT $45.00 FEE DETAIL Fee Description Invoker/ Quantity Foe Amount Current Pald Fire Alarm or Securly System 41785 1.00 64500 645.00 645.00 645.00