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Home My WebLink AboutBLDE-19-002234 i Commonwealth of Official Use Only tEI Massachusetts Permit No. BLDE-19-002234 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked , [Rev.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:10/15/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 28 BRAY FARM RD SOUTH Owner or Tenant WILLARD PRISCILLA M Telephone No. Owner's Address 28 BRAY FARM RD S,YARMOUTH PORT, MA 02675-1555 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 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement boiler. 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 Transformer KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- 1:1No.of Emergency Lighting grnd. ;rid. 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 Tons 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 Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Sitns 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 fdesired,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: EDWARD M LYNCH Licensee: Edward M Lynch Signature LIC.NO.: 35609 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 WIDGEON LN,WEST YARMOUTH MA 026733818 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 • 077¢ ‘c) I(8 fie 15 2018`1 Commonweatlh oil///adeachaorif! Ater er Onl 7 Pyt 4tf Tjb, nit_ t c�7't Permit No. B. yAler ii-PART ME NT apartment o��J`i,v-eroiae BY lV,t Occupancy and Fee Checked m, y :• • -D OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM EL CT- CAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M C),527 N '_.00 (PLEASE PRINT IN INK OR TYPE ALL INFO2i1LIAtO Date: a s City or Town of: �/ ( ci Poi To the Insp+ctor o Wires: By this application the undersigned to es not of h'. or tention t p.1" n the ele tricot work described below. Location(Street&Num er) i if not') a L/ .0 Owner or Tenant f/' '6 C / / ifr I Jr Telephone No. Owner's Address ,Jnrb'r�6 • Is this permit in conjunction with a bonding permit? Yes ❑ No ❑ (Check Appropriate Box) , • Purpose of Building Utility Authorization No. Existing Service_ Amps / Volts Overhead❑ Undgrd El No.of Meters _ New Service _ Amps / Volts Overhead El Undgrd El No.of Meters _ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (' %,l 4 e (to' let .. I / 1( Completion of the followin; table may be waived by the Inspector of Hires. V: otal th No.of Recessed Luminaires No.of Ceil.-SansP.(Paddle)Fans Trai KTransformers KVA SiKVA No.of Luminaire Outlets No.of Hot Tubs Generators -t No.of Luminaires SwimmingPool mei Above ❑ In- ❑ No.of Emergency Lighting grad, grad. Battery Units '•i No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones i Na.of Switches No.of Gas Burners No.of Detection and Initiating Devices I U 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 P Totals: " I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local r—: Connectionpal ❑ Other yy No.of Dryers Heating Appliances KW Security No. f Devices s or Equivalent No.of Water No.of No.of Data Wiring: VV e ICvices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications v No. f Devicesor Wiring:valent • 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: 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 coy ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties ofperfury,that the information on this application is true and complete. FIRM NAME: '/ ,f LIC.NO.: Licensee: _it AA Al L G // Signator l SIC- � �/ld LIC.NO.: 3 fbo (If applicable, ; t r 'ese pt"snipe license 'giber line /� Bus.Tel.No. Address:applicable,,, e• 1�• Engr' �) /- Alt Tel.No.: /% if-dog-59399 *Per M.G.L.c. 47,s. -61,security work rain s Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aw re that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. 1 am the(check one)0 owner 0 owner's agent. Owner/AgentPERMIT FEE:$ Signature Telephone No.