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Home My WebLink AboutE-19-3363 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-003363 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:12/4/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her Intention to pertonu the electrical work described below. Location(Street&Number) 10 JANNOR WAY Owner or Tenant KORBEL EDWARD G Telephone No. Owner's Address KORBEL MURIEL D, 10 JANNOR WAY,WEST YARMOUTH, MA 02673 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 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement boiler. a 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 TVA 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 iiiNo.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/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 Stens Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: 3 Attach additional detail Ifdesired,or as required by the Inspector of Wires. i 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: MARK B KIEFER Licensee: Mark B Kiefer • Signature LIC.NO.: 26093 (If applicable,enter"exempt"in the license number line.) - Bus.Tel.No.: Address:53 GRASSY POND DR, DENNIS MA 026382515 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 eD cls--7(8 ttrr �rW�� II g4 l.,n omswnwea[h o` aeeachaertte Official Use Only �?,1 r7� cc�►/ �7 Permit No. ,. r;'E+' 2)epartment o`Jirr Smoked y1 Occupancy and Fee Checked ha BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] (leave blank) 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: I! - 30'07-0 I T' City or Town of:yea ea e 'h p(/-('h 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) JO 7iei NO l2 1.124-& Owner or Tenant 1--e_ -j Kot Sgi • Telephone No, g V Owner's Address <eMt f Is this permit In conjunction with a bulldinf permit? Yes 0 No 53 (Check Appropriate Box) r Purpose of BaildingR PS I,n e cot A L Utility Authorization No. Existing Service_ Amp / 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: p c'f a b1 - lie ,, RtTplt46oLbPtvT ! lNiEiNs 2 $C �naL'7i .• t Completion of the followinttable may be waived by the Inspector of Wires. vi W re No.of Recessed Luminaires No.of CeiL-Susp.Waddle)Fans No.No. oT t Transformers KVA Ll No.of Luminaire Outlets No.of Hot Tubs Generators KVA C, -t No.of Luminaires Swimmin Pool Above In- No.of Emergency Lighting g grand. ❑ turd. ❑ BatteryUnita J No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones F No.of Switches No.of Gas Burners / No on initiatinggDetection Devices _ I U No.of Ranges No.of Air Cond. TotalnNo.of Alerting Devices No.of Waste Disposer Heat Pump Number, Tons 1tKW No.of Self-Contained Totals: f T Deteetlon/Alerti g Devices No.of Dishwashers Space/Area Heating KW Local 0 Moneectunicipalioo ❑ Other C 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 orEonlvalent No.Hydromassage Bathtubs No.of Motors Total HP telecommunicationsNofDevceor Equivalent No.of Devices 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: fl. 3O perg 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 a BOND 0 OTHER 0 (Specify:) i certify,under the pains and penalties ofp, my,that t informal!,n otj this application Li true and complete. ' FIRM NAME:i'rf'4g.K. k / e A,ieOt ' LIC.NO.:F�Og License: /)] A A /k. E/r p. �GZ, Signaturc ]/�� i y� LIC.NO.: 7 (If applicable enter" xempt"in the license ma" line.) :us.TeL No.` �! 71 Address: — / .A as* 1 ., ' rI r Alt.TeL No.: 'Per M.G.L.c. 147,a.57-61,secur work 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 am the(check one)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:S