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Home My WebLink AboutBLDE-19-3028 Commonwealth of Official Use Only E4, Massachusetts Permit No. BLDE-19-003028 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.1/071 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:11/16/2018 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 SURRY LW Owner or Tenant CABRAL ADALINO Telephone No. Owner's Address CABRAL MARY C, 10 SURRY LN,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 ❑ 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 Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA IN No.of Luminaires Swimming Pool Above ❑ In- a No.of Emergency Lighting AT grad. Battery Units -p„ No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 11 No.of Switches No.of Gas Burners 1 No.of Detection and n 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 ❑ 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 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: RICH M MELVIN Licensee: Rich M Melvin Signature LTC.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 iscry.A&Necik /a/fJ , t Official al s�Only �C� • CommonweaCfh o ri/addac�cudeffd ( /i1(� 1 - , cc�� cc77 ((�� Permit No, mUeirarirnent oi.%a Jarelced Occupancy andFee Checked BOARD OF FIRE PREVENTION REGULATIONS •ev.1/07] eaveblank • APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the MassachuseffsElectricalCod I(HEC],327 M12.0 (PLEASE PRINT INIMKOR ' ALLINFORMATTON) Date: I II III 7777 City or Town of: t,I a iia To the Inspector of Wires: • By this application the undersign. lives notice of his or her intention to performthe electrical work described below. . Lf¢ation(Street&N\\umber) i i U//4 L il A , t 4✓ I ' '0 7 3 ]gQ• Owner or Tenant ''Cda\t`hn (hbi9 TelephoneNo. 5 $1. Owner's Address Sol rA Q Is this permit in conju ction with a building permit? Yes 0 No (Check Appropriate Box) Purpose okBuilding Vvt/?lb Jig Utility AuthorizationNo. Existing Service^ Amps J 1 Volts Overhead 0 Undgrd 0 No.of Meters New Service _ Amps I Volts Overhead Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature oYProposed Electrical Work: ' 01 i'r h I, 0 orn bewatvedb the InsThcoro Wires. ' • Comdetiono the ollowin:tale • .of No.of Recessed Luminaires No.ofCeil.-Susp.(Paddle)Fans Transformers RVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA f.ove '0.o 'mer:envy ug No.of Luminaires Swimmingreel g nd ❑gr0 ad Battery Units No.of Receptacle Outlets. No.of OilBurners 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. Total No.of Alerting Devices _ Tons .eat'umumber ons _`-�� o.ofelf-Containe. . No.of Waste Disposers Totals u._•_.._—� Detection/AIer Devices Mumcrpal 0 Other No.ofDisliwashers Space/AreaKeating KW Local❑Connection_ Security Systems:' No,of Dryers Keating Appliances KW No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: HeatersKW Signs Ballasts No.of Devices orEuiYale12t • Telecommunications Wirin : No.ItydromassageBathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail ifdestred 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 coverage is in force,end has exhibited proof of same to the permit issuing office. O • CHECK ONE: INSURANCE Er BOND 0 OTHER 0 (Specify:) (tendon If true and complete T certfy,under the pains road penalties of perJury,that the Information on this app _ ., FIRM NAME: co NSLpa1 •(u�d w {-et, r' • ••• • • LIC.NO.: o / •// LIC.NO.:o01 Sa`J' J Licensee: ( (L0 fri au S{gnatare • (lfappllwble,entgr `exm t_"inthel(censen berline.) Tel.No.: 2-219 r Address: 'A /Lt/Y/LtDON01fgat 5vittf•( �t�/1'{oiCi"I-]t1�4 kb ' Alt.Tel.No.:—____— a o- "Per Kat.c.147,s.57-61,security world requires Department of Public Safety"S"License: Llo.No. . ____-- OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability hu urance coverage normally 0... required by law. By my signature below,I hereby waive this requirement. 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