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Home My WebLink AboutBLDE-20-001086 Commonwealth of Official Use Only or. +�` ` Massachusetts Permit No. BLDE-20-001086 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:8/27/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 42 STANDISH WAY Owner or Tenant HORAN JOHN J Telephone No. Owner's Address HORAN DONNA J, 30 VINCENT AVENUE,WORCESTER, MA 01603 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: Replacement boiler. 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 1 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 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 SignatureQ��' (1 Telephone No. PERMIT FEE: $50.00 I( 3 ze k i o� c ll��1- c g�923s6 C � _„A ' _ Commonweahh V o�Massachusetts Official Use Only �� _ -. 01 2 eparfinent o f.fur Services Permit No.C J I o FJ tG - BOARD OF FIRE PREVENTION REGULATIONS Occupancy I/07cy.and Fee Checked •"•` [Rev. 1/07) (leave blank) ---- - APPLICATION FOR°PERMIT TO PERFORM ELECTRICAL WORK i in -•-,-----,Z I All work to be performed in accordance with the Massachusetts Eiecuical C C),527 CMR 12.00 1,ij t _,, 3;t PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: >`�N i Q To the Inspect City or Town of: YARMOUTH ��6 oy� �� r o Tres_ �� r,;y this application the pndersigned •gives notice of his or her intention to perform the electrical work described below. 1i. o i °cation(Street&Number) s f I� er or Tenant 9 �J Q i L 3 '= u wner's Address t l Q �1 Telephone No. F i_ r this permit in conjunction with a buildingpet-nut? n Yes ❑ No L. (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service s / Volts Overhead ❑ Und grd❑ No.of Meters — New Service Amps / Volts Overhead❑ Undgrd t;r ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical 15o, idei/i Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cei1.-Susp.(Paddle)Fans No.of Total Transformers KVA _ Zj No. of Luminaire 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 Ott Burners FIRE ALARMS [No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating_Devices Z No.of Ranges No. of Air Cond. Total No.of Alerting Devices • No.of Waste Disposers Heat Pump !Tons Tons I KW No.of Self-Contained Totals:I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local D Municipal Connicnection ❑ Omer No.of Dryers Heating Appliances KW Security Systems;* No.of Water No. of No.of Devices or Equivalent 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: Estimated Value of Electrical Work Attach additional detail if desired or as required by the Inspector of Wires. Work to Start: (When required by municipal policy.) Oje/7 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCEVERAGE: 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 k 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.) r I certify, under the pains and penalties ofpe jury,that the information on this application is true and complete. FIRM NAME: LLl ofll LIC.NO. Licensee: GA/ Signature (If applicable,enter"exempt"in t teens er i e. LIC.NO.: Address: us. .No.: CS �+— J "Per M.G.L. c. 147, .57-61, •ty work requires Department o Public Sae Tei.No.: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n— o ly ac required by law. By my signature below,I hereby waive this requirement I am the(check one ❑owner 0 owner's a eat. Owner/Agent ll Signature- Telephone No. PERMIT FEE: $ 60