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Home My WebLink AboutBLDE-18-003716 A. ld r Commonwealth of Official Use Only FMassachusetts Permit No. BLDE-18-003716 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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:12/26/2017 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) 62 DESERT SANDS LN Owner or Tenant KELLEY JOHN D Telephone No. Owner's Address KELLEY BETH,62 DESERT SANDS LANE,YARMOUTH PORT,MA 02675 y¢/ e t C Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A ate B<`0 Purpose of Building Utility Authorization No. Cv3/ Q Existing Service Amps Volts Overhead 0 Undgrd 0 No. s e j New Service , Amps Volts Overhead 0 Undgrd 0 No.o fl ' Co Number of Feeders and Ampacity O /� Location and Nature of Proposed Electrical Work: boiler swap(508-400-2233) (frit O f//� Completion of the following table ay be�Aived by t . - ..fWires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of `�j] Transformers e• No.of Luminaire Outlets No.of Hot Tubs Generators KVA. No.of Luminaires Swimming Pool Above 0 In- ❑ No.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 No.of Detection and Initiatine Devices ' No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tonsi KW ,No.of Self-Contained Totals: Detection/Alertinc 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 Siens Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total IIP Telecommunications Wiring: No,of Devices or Eauivalent 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: Jesse R Ling Licensee: Jesse R Ling Signature LIC.NO.: 15646 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 1200,WEST CHATHAM MA 026691200 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 19A- 1/c/lkr IP/2‘,GP r: . ,., .. SI,. Commonwealth of Massachusetts Official Use Only 1 ,r �re Department of Fire Services Permit No. n %.tfE Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (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 ORITPPEALL INFORMATION) Date: 11 `3d*re k1 City or Town of: 7r/0.k4Qxt( To the Inspector of Wires: By this application the undersigned gives noti of his or her intention to perform the electrical work described below. Location(Street&Number) L9' " .cot ' RJVR � Le..n& Owner or Tenant Soft& K�(le Telephone No.SOB-362,-13X 1 Owner's Address S AMC. Is this permit in conjunctionrzith a buildding•permit? Yes 0 No IE (Check Appropriate Ax) Purpose of Building J-) tl-, ca tla Utility Authorization No. 74 Existing Service ' la°Amps ( 1v / aaCVolts Overhead®. Undgrd 0 No.of Meters e New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity 4Pas, pt-( ( ,Z Location and Nature of Proposed Electrical Work: Cot_(� S..(1)F P Completion of the following table may be waived by the Inspector of Wires. \No.of Recessed Luminairs No.of Ceil.-Susp.(Paddle)Fans TrNoansformers of Total KVA No.of Luminaire Outlets No.of Hot Tubs . Generators Ir. No.of Luminaires "--- _ . g Swimmin Pool Above ❑ In- ❑ No.of ! mergency mg Brod. grnd. Battery Units No.of Receptacle Outlets \--No`of Oil Burners FIRfi..ACCIRMS No.of Zones No.of SwitchesNo.of Ga . I 3'Bu .ers o. nDetention and nitiating Devices No.of Ranges No.of Air Cond. T ns No.of Alerting Devices No.of Waste Disposes Heat PumpNu _!� Tons_ - No.of Self-Contained P Totals: -' '' - �etection/AlertingDevices No.of Dishwashers Sp res Heating KW I ^3'a connecdon il ❑ other No.of Dryers Heating Appliances KW Security Syys fems rY No.otDevices quivslent No.of Water No.of No.o(' Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hyd�a�ge Bathtubs No.of Motors Total HP TelecNo.of Devic orsonEquivalent OTR: • • e Attach additional detail(fdesired or as required by the Inspector of Wires. Estimated Value of Electrical Work: 4 1 00 (When required by municipal policy.) Work to Start: i?. (- ( 7 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 coverage1.�� is in force,and has exhibited proof of same to the permit issuing office. t_f' CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the informationon this application is true and complete t FIRM NAME: l..fo la ['C2c-e1AY-tiCA--I LIC.NO.:4i 646, Licensee: 3.9,, ( pcb Signature t-. y LIC.NO.:E 3a43`c (Ifapplicable enter"exempt"in the lice�tse number line.) Bus.Tel.No..Cob-VGo-�3'� Address: '`'SOX t't iso W .C.fi R-Ctke1Yt MN ati Alt.Tel.No.: _ *Security System Contractor License required for this work;if applicable,enter the license number here: 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/AgentPERMIT FEE:$ � Signature Telephone No. 50