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Home My WebLink AboutBLDE-19-001725 1a Commonwealth of Official Use Only & Massachusetts Permit No. BLDE-19-001725 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:9/21/2018 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) 166 SPRINGER LN Owner or Tenant NEU STANLEY E Telephone No. Owner's Address NEU K DIANE,PO BOX 45, MANLIUS,NY 13104-0045 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 0 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: Replacement boiler&water heater. Completion of the following table may be waived by the Inspector of Wises. 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. Batten,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 Initiation 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 ❑ Municipal ❑ Other: _ Connection No.of Dryers Heating Appliances KW Security Systems:* No,of Devices or Equivalent No.of Water 1 KW No.of No.of Data Wiring: Heaters Stens Ballasts No.of Devices or Enulvalent _ 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 certify,under the pains and penalties of perjury,that the information on this application Is true and completes 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 Ito(t8I`8 1 - A Comnwnweargo rr/amachueetie Official Use Only ,�- EEt �/` t t ��] `n- PermtNo. � P sitt 5 25epartment el Jiro Serviced ktIT Oy Occupancy and Fee Checked t sz BOARD OF FIRE PREVENTION REGULATIONS [Rev 1107] (leavebla _____— • — • APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to beperformed in accordance with theMassachusetta Electrical Code r ),327 r 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMADate: do /1 AP City or Town of: t4r�'1Ourrili (,J2� To the Inspector of Wires: By this application the undersign d gives noa of his or her intention to�perform the electrical work describedbe w.. L'ocation(Street&Number) //p ' 3(AovbZ'C G14,vg. 3 Owner or Tenant fi Ao,- 2fltaad* Telephone NO.�_ Owner's Address 6,9n-1 a. Is this permit in conjunction with a building permit? Yes El No " (Check Appropriate Box) Purpose otBuilding •.O-2,4L/A'6- Utility AuthorizationNo. Existing Service^ Amps • / Volts Overhead 0 Undgrd❑ No.of Meters _,_ New Service _ Amps / Volts Overhead❑ Undgrd 0 No.of Meters _— Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: '1/ . ! 1/2t-GT Completion of thefollowingtablent bewaived6 the Ins ectoro Wires. No.o Total No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Transformers ISA • No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool , d, ❑ :. d. ❑ Batter Units _ _ - No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. TtTons No.of Alerting Devices 1 No.of Waste Disposers eat ump umber Tons _Pr_ No.oFSelf-Contained Totals: Detection/Alerting Devices MunicipalOther. No.of Dishwashers Space/Area Heating KW Local❑ Connection 0 -ecurity Systems:" No.of Dryers Heating Appliances KW No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices orB uivalent •I'e eco " '• wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent 0-- OTHER: . Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Vo Work to Stad: 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 0 (Specify:) pp \ I certify,under the pains and penalties of perjury,that the information on this application is true and complete. l�) • LIC.NO.: .�j� lG FIRM NA � IJ NSCow •L[t. 3 � �1 r �� LIC.NO.:�IS�� VIO Licensee: (CF(f{(GQ `L'LViIV Signature f (fapplicable.ent "exem.t"In the license nw rber line.) �' Bus.Tel.No.'K/33 9'!i5 Address: ' ' v/ ION itad 'ala dtr •a m ' 0 bL Alt.Tel.No.:�— 'Per M.O.L.0.147,s.57.61,security wor requires Department of Public Safety"S"License: Lk.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally tequired by law. By my signature below,I hereby waive this requirement. I antthe(check one 0 owner 0 owner's a:ent. 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