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Home My WebLink AboutBLDE-20-0010256 Commonwealth of Official Use Only ifE` 1 Massachusetts Permit No. BLDE-20-001025 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:8/26/2019 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) 19 STABLE LN Owner or Tenant SOLTOFF HOWARD M Telephone No. Owner's Address SOLTOFF JANE E, 8819 BURDETTE RD, BETHESDA, MD 20817 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: A/C replacement. 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 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 ❑ 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 ❑ BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: KUNG-PO TANG Licensee: Kung-Po Tang Signature LIC.NO.: 52286 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:518 COTUIT RD, MASHPEE MA 026492351 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 eikj--- l27f(9 e .,/ ��_ eo of2 l�a<l th Official Use Only _ s�+� = 2eparfi ent o f�i,v Services PermitNo. �� z S -t-- _ _ BOARD OF FIRE PREVENTION REGULATIONS v0 .ccupancy and Fee Checked • I/07] (leave blank) - APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK }I All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 �, ( SE PRINT IN INK OR TYPE ALL INFORMATION) Date: �S- 2 '(g �' City or Town of: Y To the Inspector 2 of Wires: t 1� 0B this application the undersigned gives noti of h. or her intention to perform the electrical work described below. OL tion(Street&Number q s`6,A4 . 1 < i cO4ner.or Tenant sbl ` Telephone No.2 fjl—3 - (9‘y 1e L.__.__iTner's Address ,--- ---Irtilis permit in conjunction 'th a uil ' g permit? Yes ❑ No yl v�� (Check Appropriate Box) Purpose of Building e z- I,t�t Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Pm I [C / efb� Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeL-Susp.(Paddle)Fans No.of Total Transformers ICVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of)Jmergency Lighting grad. mid. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas Burners No.of Detection and -' Initiating_Devices No.of Ranges No. of Air Cond. Total -7 C Tons Z No.of Alerting Devices No.of Waste Disposers Heat Pump Number No.of Self-Contained Totals:I ITons KW Detection/Alerting Devices t No.of Dishwashers Space/Area Heating KW' um/❑ Municipal v Connection ❑ other No.of Dryers Heating Appliances , Security Systems:* ' No.of Water No.of No.of Devices or Equivalent No.of Heaters KW Data Wiring: Signs Ballasts No.of Devices or Equivalent q. No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent lV OTHER: Estimated Value of Electrical Attach additional detail if desired or as required by the Inspector of Wires. �� Work to Start L /pWork (When required by municipal policy.) / Inspections to be requested in accordance with MEC Rule 10,and upon completion. SI 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 undersigned certifies that such coverage is in force,and hasexhibited proof of same tothe permit issuing ofcentvalent, The CHECK ONE: INSURANCE 18 BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete.) FIRM NAME: —7 LIC.NO.: Licensee: Signature (If applicable,enter" e t' in he I. a LIC.NO.: �� B Address: ��(� ,vti, mUS�et {,.( Z6f) Bus.Tel.No.: '70g J *Per M.G.L. c. 147,s.57-61,security work rooc Safety Alt.Tel.No.: ,-;-c OWNER'S INSURANCE WAIVER: I am aware thatptheLicensee does not havethe liability Lin.No. S required by law. By my signature below,I hereby waive this requirement. I am the(check one tnsuo rice coverage n'ors a e t Owner/Agent 0 wrier ❑owner's a �t Signature_ Telephone No. PERMIT FEE: $