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Home My WebLink AboutBLDE-19-002932 Commonwealth of Official Use Only •Ems; 44\ Massachusetts Permit No. BLDE-19-002932 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:11/13/2018 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) 32 TABOR RD Owner or Tenant JOHNSON BRADFORD A Telephone No. Owner's Address JOHNSON JUDY A,32 TABOR RD,WEST YARMOUTH,MA 02673 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd ❑ 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 No.of Luminaires Swimming Pool Above ❑ In- 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 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 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 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 El (Specify:) l 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 LIC.NO.: 21829 Qfapplicable,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 )8C1 IGs C/C /d,�✓, f 9 • nunonWea 0 mime 9 ��_.�n rj n g9 Merriment y nn PermitNo. _ —�-- — ", sUePar{Yn9nto�JireJaevlces andgeeChecked__�_ • a , Occupancy`, a" BOARD OF FIRE PREVENTION REGULATIONS ev.1107] cave blank . APPLICATIOto N FperOR PERMITed in accordance TO PERFORM ELECTRICAL Blectical Code WORK (PLEASEPRINTITINKORWEALLIEF'ORMATION) Date: ,, , City or Town of: Itl&M ill; To the Inspector of Wires. By this application the undersigned give notice o�fhC�or her intention to perform the electrlcalwork described.below. � LWation(Street&Number) &L,0/ t< ' ast t laSQg715 -72TelephoneNo, OwnerorTenant � Ohl a Owhbr'sAddress riateBox) Ts this permit in conjunction with j building permit? Yes 0 No �CheckAppro p purpose of'Building 1��+'t(1 No AuthorizationNo. 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 Lo cation and Nature of Proposed Electrical Work: 3, ',` 'A ltt 01 • • Com•letiona the dlowin:`bleom, bewaivedb the! Aro Flares. ' To No.of Recessed Luminaires No.of Cei.-Susp.(Paddle)Fans Transformers • No.of Luminaire Outlets No.of Hot Tubs - `0.o' mertency gat g No.of Luminaires Swlmova mingPool : ad, :. nd. 0 Bette_Units No.of Receptacley . • . LMNIo cation.and NatFIREALAMAS O o.oteaction an' • No.of Switches : Initiatin:Devices No.of Alerting Devices No.of Ranges 2=1111M3111111, ,, o.of el- ontaine.gDevi :eat'ump Number DetectionfAlertrn:Devices No.of Waste Disposers Totals: Tnmcipal �]Odror No.of Dishwashers Space/AreaHeating TCW I,ocalr,Connection " No.of Dryers ecurity stemsNo.of a evices or E.uivalent r , 10 o `0.o Data Wiring: I Si; s Ballasts No.of Devices or Et tivalent e ecommunicat ons T firingg. • No.HydrpmassageBathtubs No.of Motors Total HP No.ofDevices or E i unieatonsTirrvalcut OTHER: Attach additional detail if desaret4 or as required by theInspector of Were:. Estimated Value of Electrical Work: (When required by municipal policy.) • Work to Start: Inspections to be requested in accordance withMECRule 10,and upon completion. unless INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may 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. • CHECIC ONE: INSURANCE ri BOND 0 OTHER 0 (Spec fy:) • • I temp,under the pains and penalties ofperJury,that the information on this application is true and Nplete \1) PIRMNAME: .. to 1)5(4W •Gitldt Lod 'r ISC.NO.:`�lS✓lY tDc 50 Licensee:�(C(•F{hU /1411,1)1(0 Signature , Bns.LIC.N o (ifapplicable,ent' "ex m.t"in the license betting.) y 0l� Address: ''/ ION (IGI 5vid be ti o ' b fe Alt.Tel.No.:_ — *Per M.O.L.c.147,s.57-61,security war requires Department of Public Safety"S"License: Lb.No. ..a normally OWNER'S INSURANCE WAIVER; I am aware that the Licensee does not have the liability insuranceer o ener's agent. Q • fequired by law. By my signature below,I hereby waive this requirement. I am the(check one) at# U Owner/Agent PERMIT FEE: Signature Telephone No.___________. °r • • • • ta— k. TheCo . _ K t Commonwealth ofMassaclt et • �f Depa,trneyttoflndustrtalAcctdertfs —iVei• I Congress Street ,,;, • Boston 'ste100 . Zit 02114--2017 gWork ' onspnomaegavt:General Sns nesses,ToBE wTHE PERagniNGAUTHORITI.A„Iicantinformation Business/OrganizationName:E.F.WINSLo Please Print Le.ibl Address;8 REARDON CIRCLE W PLUMBING&HEATING CO.,INC • �ity/State/Zip:SOUTH YARMOUTH, re you an em MA 02684, . ployerlCfiec$thea Phone#;60839q.7778 Iaan employ r?oyer Chith PPr'opriatebox: or part-time).* MI_employees Business Pa(requtred): Iamasola (full 5. ❑Retail . employees pmpriefor or • Working for me om�pattdhavano 6. QRestaurant/Bar/EatingEstablishment [No workers'camp,insurance required]any capacity. ry 7' D Non-Officeprofit and/or Sales ' We are a corporat on (mcL real estate,auto,etc.) • Wrreatofexemptionoand its officers have exercised .. Entertainment nhimplhtof. perc.152,§1(4),andwahava I0 Entertanment We • azo anon-profit porkers comp,insurance required? 10 Q Manufacturing no employees. rg�tion,staged by volunteers 11.0 Health Care ;grantih no checks must No workers comp.insurance ' t attuecksbo ust�0 fill out the section below sho ] 12.[�Otherompens ' atm,should check box#exempted themselves,but the co vaaBtheirwnrkers' ' rporationMe other employees,a workers'ocompensationpoi on. nein/ yer thal7sDrovLi ..__. compensation cyerequiredmdevch an lee CompanyN a ARROW MUTUAL insurmtc—� AL INSURANCE COMPANY Below sthepoUcyinformation. 'a Address:23 COMMON MPANY WEALTH AVE ' rtnZip; CHESTNUT HILL,MA 02487 • !or gelitintLfo.#1821A • r coPY of the workers'compensat on policy declarat oa nsecurofthera a Expiration Data:01/01/20)fr g asrequuedunderSecttonPaga(showing ttre otic 3 secure coverage,as r policy w0 o and nor 250.00 day one-year n°Prisom ent 25A ofMGL c,152 can lead to the imposition ofcriminaln'at on date), against the violator, as well as civil penalties in the form lions 0,5090 aa for the,vice Beevoradvised ofaSTOPp70 pcnaltesofa coverage that a copy ofthis statement may be forwarded to the 0 andof a fine Sy Corte • g verification. _ the,ails aad.-naltieso peJ�urythatthe7nformat7on • 7 ` provided above trhue and correct. 08-394.7778 • Date; / 7 • useonly,Do nod write la this area,to be --- comp7efedby ctly or town officialI 'own: • uthortiy(�eeone): Permlt/License# ofHealth 2.Bn ldin gDepartment 3.—nig,Pawn Clerk 4.Licensing Board 5.Selectmen's Office , arson: Phone#: Wvnvmeayeov/dia