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Home My WebLink AboutBLDE-19-003653 • Commonwealth of Official Use Only 1 A Massachusetts Permit No. BLDE-19-003653 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:12/17/2018 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. London(Street&Number) 32 HOMESTEAD LN Owner or Tenant OHRN JOAN D Telephone No. �y��,',, , /', q Owner's Address 32 HOMESTEAD LN,YARMOUTH PORT,MA 02675-1221 l_afACA4-IAA Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. �J�s.1/ ` Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade of service — 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 0 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 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 ❑ OTHER 0 (Specify:) /certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: MICHAEL S SOBY Licensee: MICHAEL S SOBY Signature LIC.NO.: 10097 (Ifapplicable.enter"exempt"in the license number line.) Bus.Tel.No.: Address:66 Lake Dr, Orleans MA 02653 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 'QN,(? ( !q !a (,U I I W Writ l VtS eC bin i kf e l.ammonurea/g o/trlamactfeOfficial Use Only _77i- cy 2i 'Permit No.(�.'I-- 1 k� .,_ para uutt o/.>c7ire services S 3 • Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev, 1ro7j (lCdVe blank) (j • APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK \ All work to be performed in accordance with the Massachusetts Electrical ode(MEC),527 CMR 12.00 :fit !t -}� (PLEASE PRINT IN INK OR TYPE ALL INFORM477O1' Date: v c_ i7 City or Town of: YARMOUTH To the Inspector of fres: V . By this application the undersigned givesqnotice of his or her intention to perform the electrical work described below. • L�C Location(Street&Number) f-J hues f !J_7 f 0 pnerorTenant Tim �,•,p�) Telephone No. Lu m 1,43! er's Address al- is I is permit in conjunction with a building permit? Yes 0 No [ (Check Appropriate Box) !SJ o ose of BuBdinglS'tA� ptqD 1./e.11 f Utility Authorization No. v IcEz sting Service /00 Amps 0217)/ de Vo is Overhead f [�. Undgrd No,of Meters _ V in `e Service "LA 11,L� { � Amps //�J Volts Overhead 0 Undgrd.� No.of Meters i' 1 c'-` ,, ;m u ber of Feeders and Ampacity Lo tion and Nature of Proposed Electrical Work: , ✓JAL., 1 -4, a I -�l.�r l` •' I. .�a /• .IBJ r ail L Ie I/. .1' _..6.4 if Completion of the followingtable may be waived by the Inspector of Woes. No.of Recessed Luminaires No.of CeiL-Susp. No.of usp.(Paddle)Fans Transformers KVA KVA No.of Luminaire Outlets No.of Hot Tubs - Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.ot-l;mergency Lighting grnd. grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained - Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' unicipal = [°cal Cl❑Connection 0 Other /.. No.of Dryers Heating Appliances Security Systems:' No.of Water No.of No.of Devices or Equivalent 1 No.of V Heaters K�! Data Wiring: Signs Ballasts Na,of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: Na of Devices or Equivalent Attach additional detail if desired or as required by the Inspector of Wires. Estimated Valu of Electrical World„Lai-- (When required by municipal policy.) Work to Start: pie_ / 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 it BOND 0 OTHER 0 (Specify:) I terrify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: /GAMS/ 5437 1//ir i G i Re LIC.NO.: it 8Licensee: //_ L Signature LIC.NO.: 4f. - 13-...... applicable,enterempt" he tcense - tuber line) Address. i us.Tel.No: . a -3� 1y�� Of/c/1 s "Si O�4c5 Alt.Tel.No.: j `Per M.G.L.c. 147,s.57-6 ,security 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 n�y ic required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent Owner/Agent d Signature Telephone No. I PERMIT FEE: S 6D