Blde-20-001227 ,or \.kl Commonwealth of Official Use Only
\ /fi- Massachusetts Permit No. BLDE-20-001227
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:9/4/2019
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) 1 AKIN AVE
Owner or Tenant SILVERMAN ANN L Telephone No.
Owner's Address 168 ELMWOOD AVE,WOLLASTON, MA 02170-1326
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 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Clean up knob&tube wiring, upgrade panel, &add smoke&CO detectors.
_ 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- ❑ 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
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 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: EDWARD L MERRY
Licensee: Edward L Merry Signature LIC.NO.: 17137
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 15 CHECKERBERRY LN,W YARMOUTH MA 026733636 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:$125.00
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Commonwealth of Massachusetts Official Use Only ZZ
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' ` tr/ Department of Fire Services Permit No. ���
. - t} _av ` BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
; 4 [Rev. 1/07] (leave blank),
APPLICATION FOR PERMIT TO PERFORM ELECTR . ,r e t D
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMA77ON) Date: 8-30-2019 " SEP - 4 2019
City or Town of So.Yarmouth To the Inspector of W rez:
By this application the undersigned gives notice of his or her intention to perform the electrical work des�4lieg*avid E PA R T M E N T
Location(Street&Number) 1 Akin St g t, ""' --
Owner or Tenant Ann Silverman Telephone No. 617-835-0963
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No *® (Check Appropriate Box)
Purpose of Building Residence Utility Authorization No. 7,11;1/5 cp 1
Existing Service 100 Amps 120/2,40 Volts Overhead® Undgrd 0 No.of Meters 1
New Service 100 Amps 120/240 Volts Overhead® Undgrd❑ No.of Meters 1
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Knob and tube remediation and upgrade panel to hold more circuits
Adding hardwired 120 volt smoke and co devices.
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 Lighting Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grad. grad. 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. To
No.of Alerting Devices
No.of Waste Disposers Heat Pump Number I 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 Hating Appliances Key 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.Hydro massage 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: 9-3-2019 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 ® BOND 0 OTHER 0 (Specify:) GENERAL COMP.LIABILITY 06/24/2020
(Expiration Date)
I cenify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Ed Merry Master Electrician Inc. ." ' Lic.NO.:A17137
Licensee: Ed Merry Signature �Z //' LIC.NO.: 35745E
(If applicable,enter "exempt"in the license number line.) Bus.TeL No.: 508-221-4335
Address: 15 Checkerberry lane West Yarmouth.Ma. 02673 Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License:here: Lic.No.
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)❑owner 0 owner's ent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$
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