The URL can be used to link to this page

Home My WebLink AboutBLDE-20-001085 Commonwealth of Official Use Only (Z' S Massachusetts Permit No. BLDE-20-001085 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•8/27/2019 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) 71 MELGO LN Owner or Tenant HARRINGTON PATRICK LIFE EST Telephone No. Owner's Address HARRINGTON EILEEN M, 141 CHURCH ST,WEST ROXBURY, MA 02132 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd ❑ No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Service change&wire A/C. 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- ElNo.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. 1 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 0 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 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:$50.00 '"*-4t 1 -,1 e if (LJo/ agn� early lromasoriwsatth oi//(assachussit • official Use only p __�' c'7i Permit No. ' 66s" r' _ .)epart n o f.Vre Servr.5 - -= BOARD OF FIRE PREVENTION REGULATIONS Ov. 1/07] .al Fee (leave blank)) • . 4 , APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK r_ All work to be performed in accordance with the Massachusetts Electrical C (MEC),527 CMR 12.00 "' - _ 4P E PRINT IN INK OR TYPE ALL INFORMATION) Date: 06 , jj d0 r `' „Cr I Cit y or Town of: YARMOUTH 1`.. . a To the Inspec or o Wires_ \' 1 �L Byl this application the dersi ed , tin gn gives notice of his or her intention to perform the electrical work described below. Ls 1.d tion(Street&Number) 7/ /� ,y 1.A�° i Q er or Tenant ,�Q,esft.� �� r� ' Telephone No. .�_ .._._._._.?9, er's Address '' ___ ..�__.._.__—Is-this permit in conjunction with a building permit? Yes hpivati ❑ No (Check Appropriate Box) A Purpose of Building Uti .Authorization No. Existing Service Ad.) Amp 1'/i k-te,VolOverhead Undgrd❑ No.of Meters New Service / j Amps c2it,I 42O Volts Overhead gi Undgrd❑ No.of Meters ___Z_ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /Tv/9 */ (. ...e.iftc-0, azeife___ i Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cei1-Busy.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmin Pool Above In- 'No.of a mergency Lighting g grad. _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. Total No.of Alerting Devices No.of Waste Disposers Heat Pump I Number l Tons 1 KW No.of Self-Contained Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water KW No.of Devices or Equivalent No.of No.of Heaters Data 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. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 14010 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE GARAGE: 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 equi agent. Thess undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE fperjury,o[�77,,�� BOND ❑ (Specify:) I cemfy, under the pains and e • s ❑ OTHER P that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Mt cii/X, 8 Signature (If applicable,enter"exempt"in the lice tuber line.) G LIC.NO.: Address cil/J � .Tel.No.: _ ! "Per M.G.L. c. 147,s.57-61,securitywork requires It.TeL No.: Department o Ylibiic Safety"S"License. Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent Owner/Agent Signature Telephone No. PERMIT FEE: $ j(�