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Home My WebLink AboutBlde-19-006461 Commonwealth of Official Use Only E Massachusetts Permit No. BLDE-19-006461 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.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:5/15/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 157 ROUTE 6A Owner or Tenant WATANABE YUJI Telephone No. Owner's Address WATANABE ALDA M, 157 ROUTE 6A,YARMOUTH PORT, MA 02675-1713 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 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: Wiring for two Mini-Split system _ f 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- ❑ 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. 2 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 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: MICHAEL S SOBY Licensee: MICHAEL S SOBY Signature LIC.NO.: 10097 (If applicable,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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $80.00 11�i�Q '/20/1 f Corrunonrusa of///assac fts - _ Official icial Use Only _ -� _/f�== apartment o f.fuv Services Permit No. =r=f `• Occupancy and Fee Checked (��' '-:,, ,r.' 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 C e C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7 City or Town of: YARMOUTH �� To the Inspector of Wires: 1 By this application the pndersigied gives notice of his or her intention to perform the electrical work described below. • Location (Street&Number) i� AAp 4, gifempz)i-kai) Owner or Tenant NAND wNI I ,r^�� ,�1 Y�7- Telephone No. ,i). Owner's Address `� / {t 4 1 9////0 LRT Is this permit in conju lion with a building permit?/ 9 Yes E Na ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. c Existing Service��Amps / /.9''olts Overhead ❑ Undgrd --� ai.._-- No.of Meters rd c.: New Service Amps / Volts Overhead E Und g E] No.of Meters aNumber of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ' 4--�� Ag-f rl!hv�- Corn le_tion of the follcrwinva le may be waived by the Inspector of Wires. 9 No. of Recessed Luminaires INo. of CeiL-Susp.(Paddle)Fans No.of Total Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingAbove In- No.oT h mergency Lighting - Pool Prod. ❑ grnd ❑ Battery Units 3 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 Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No,of Self-Contained Totals: DetectionJAlertinQ Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal - _ Connection �'� No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No. of No.of Heaters KWData Wiring: 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.lilt Estimated Value ctrical Work J Work to Start: 'v Y (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VEI : Unless waived by the owner,no permit for the performance of electrical work mays proof of liability issue unless � the licensee provides insurance including"completed operation"coverage or its substantial equivalent, The ,i 1 undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. I) VI` CHECK ONE: INSURANCE 5a___BOND ❑ OTHER ❑ (Specify:) 0 1 I certify, under the pains and penaltie f perjury,th t e information on this application is true and complete, t 1,1i FIRM NAME: LIC.NO.:j Ill Licensee: i:; Signature ../Z.6 j (If applicable. enter 'exempt"in t tense tuber • ,) I' LIC.N O.: II . Address us. el.No.: Air .� *Per M.G.L. c. 147, s. 5 -6 ,securityre Alt.Tel.No.: wor quires 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 5 required by law. By my signature below, I hereby waive this requirement I am the(check one)❑owner ❑owner's agent_ 7 Owner/Agent I Signature Telephone No. I PERMIT FEE: $ k 'l