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Home My WebLink AboutBLDE-19-002164 Commonwealth of Official Use Only EE�.i►{ Massachusetts Permit No. BLDE-19-002164 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked LRev.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:10/11/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertain the electrical work described below. Location(Street&Number) 94 WHARF LN Owner or Tenant WATANABE YUJI Telephone No. Owner's Address WATANABE ALDA M,94 WHARF LN,YARMOUTH PORT,MA 02675-1140 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 ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement boiler. Completion of the following table maybe 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 0 In- ❑ No.of Emergency Lighting gird. gird. 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 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 Water KW 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: 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: MICHAEL S SOBY Licensee: MICHAEL S SOBY Signature LIC.NO.: 10097 (If applicable,enter"exempt"in the license number line) Bus.Tel.No.: Address:66 Lake Dr.Orleans MA 02653 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) ❑ owner ❑ owner's agent. Owner/Agent Signature Q Telephone No. PERMIT FEE:$50.00 C/ ts`EJ a . �LU z ty� m l.ommonwca o//rlaaaacLaseIIS 01 U l') `0 t �j cc--�t� c7 r� Permit No. W O . Ziidiw, • 2spartmsnt of.tin&rakes - ' tin*Sr Occupancy and Fee Checked 0 t, 0, BOARD OF FIRE PREVENTION REGULATIONS (Rev. (leave blank) C-.) z' lil C) A'• PLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ct" S .. All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 m 24SE PRINT IN INK OR EALL 1NF MATION) Date: �iy— nTD(g City or Town of: P$14e Q� To the Inspector of Wires: By this application the undersign gives do a of is or er intention to rform the electrical work described below. Location(Street&Number) •//t! 147r Ui / . ,- ..t d Owner or Tenant 4 C]-e'* H prra AltecTelephone No. Owner's Address • Is this permit in conjunctionncSwith a buil 'mg permit? Yes 0 No [1— (Check Appropriate Box) , Purpose of Building `),tiro M loth/) Utility Authorization No. i Existing Service_ Amps 1 Volts •erhead❑ Undgrd❑ No.of Meters New Service _ Amps i Volts Overhead❑ Undgrd ❑ No.of Meters _ Number of Feeders and Ampacity SaTtion and Nature ot Proposed Electrical Work: t v? eine' '1 ..._t)�i•e:::,4 9tC Completion of the following table may be waived by the Inspector of Wires. vri No.of Total Lit No.of Recessed Luminaires No.of Cess.-Sasp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA ' -t No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grad. grnd. Battery Units `I No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones ;� No.of Switches No.of Gas Burners No.of Detv Initiatinnggon Devic ces Ili No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons No.of Self-Contained Totals: 'I I KW Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipalnnection ❑ other Co No.of Dryers Heating Appliances KW Security of Device:* s 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 Noo.of Devices or Eq Wiring: 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: Q47—7 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, BOND 0 OTHER ❑ (Specify:) I certify,under the tali. and penal' ofperju hat the information on this applications is true and complete• p FIRM NAME: /elf ��,y�7•94.1 LIC.NO.: e2,77M Licensee. // 1 _sir/ Signature /%` LIC.NO.: iAI i (If applicable, ter"exempt"in th license In •er Inc.) I . Tel No.- _ �-i- S Address: .2 A- lib I. : /a. Le! - __iC — Y Tel.No.. *Per M.G. ,t� _7, 5 ., e ••ity w+w+requires Department of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER: i ant 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/AgentarePERMIT FEE:$ Signature Telephone No.