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Home My WebLink AboutBLDE-19-002089 Commonwealth of Official Use Only or/ Massachusetts Permit No. BLDE-19-002089 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/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:10/9/2018 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) 467 WEST YARMOUTH RD Owner or Tenant MUNCEY THOMAS B Telephone No. Owner's Address 30 BUNNY RUN,CENTERVILLE, MA 02632 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 ❑ 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 furnace. 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 ❑ ln- 1:1No.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 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tont 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 ❑ Municipal 0 Other: Connection 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: 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 certtify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: RICH M MELVIN Licensee: Rich M Melvin Signature LIC.NO.: 21829 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:8 REARDON CIR,S YARMOUTH MA 026641207 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:$50.00 1 ist23(ts A4t v �- 1 �NJI4 ' ti A CommonweaOfficial Use Orii lth o�rr/a�ac�effa 1 /G�'7�n ;gi c ec�� `n Permit No. "l ] Theparfinenf o/Jiro Services e1@ s Occupancy and Fee Checked s 6 BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leaveblank) • 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 INORMATION) Date: I Q /5 / 1 t3 City or Town of: \in fill Q 1/ lee To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform'the electrical work described below. .1 L7eation(Street&Number) 61 , Or h. ° d Y. Inv h 02.61 Owner or Tenant TA# q y / Telephone No. . 3g306t23 Owner's Address h : i a , p A 44- /p e S. 626 a Is this permit in conjunctionwith a , tiding permit? Yes El No tU/ / (Check Appropriate Box) Purposeoflluilding 'Dwellirirth Utility Authorization No. Existing Service_ Amps / Volts Overhead❑ Undgrd❑ No.of Meters __ • New Service Amps / Volts Overhead Undgrd 0 No.of Meters Number of Feeders and Ampacity 1 i Location and Nature of Proposed Electrical Work: 6�,s Fwaicc in57Q lR rte/1 Completion of thefollowing table may bewaived bythe ITotaoro Wires. No.of Recessed Luminaires No.of Ceil.-Sus .(Paddle)Fans No.of p Transformers I{VA • No.of Luminaire Outlets No.of Hot Tubs Generators KrA Above I¢- 'No.of Emergency Lighting No.of Luminaires SwimmingPoold ❑ grad. ❑ Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection andInitiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons .KW No.of Self-Contained P Totals: Detection/Alerting Devices Municipal Other No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ No.of Dryers HeatingAppliances KW -Security of Systems:"vior PP No. Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Si: a Ballasts No.of Devices orE.uivalent e ecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: 0 Attach additional detail if desirech or as required by the Inspector of Wires. MIn Estimated Value of Electrical Work: (When required by municipal policy.) -- (41 • Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. 00 ("- -4-- INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless 1/4„0 IP the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The tp 3. undersignedcertifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. 'r . CHECK ONE: INSURANCE El BOND 0 OTHER 0 (Specify:) S • I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRMNAME: ( (t) NSLOW •ta 3 • 4- t '-IJ r ' LW.NO,: .32« Licensee: (aWo Ili gLfg) Signature i A -4/ LIC.NO.,r:911 gni t'� (If applicable,ent exempt"in the license nu ber line.) ,' Bus.Tel.No.'�-68. re Address: air) Cttcie 50U be otb ti " Cr b� Alt.Tel.No.: *Per M.O.L.c.147,s.57-61,security worlf 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 ant the(check one)0 owner 0 owner's agent. 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