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Home My WebLink AboutBlde-19-006416 Commonwealth of Official Use Only E Massachusetts Permit No. BLDE-19-006416 • 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:5/13/2019 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) 30 GARDINER LN Owner or Tenant AUSTIN ROBERT C Telephone No. Owner's Address 30 GARDINER LANE, SOUTH YARMOUTH, MA 02664 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 Initiatine 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 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: Roger A Medeiros Licensee: Roger A Medeiros Signature LIC.NO.: 17183 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 365, HYANNIS MA 026010365 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 SL_ (13/ Commonwealth of Massachusetts Official Use Only= —it Permit No. C��CZ "t(� _= i Department of Fire Services '' c-?_(- Occupancy and Fee Checked ° � BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) .. ii 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: 5/10/2019 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) 30 GARDINER LANE Owner or Tenant ,edOc p TT �s--/ � i J N Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑X (Check Appropriate Box) Purpose of Building RESIDENTIAL Utility Authorization No. Existing Service / Volts Overhead Undgrd❑ No.of Meters Q Neil/Se ice Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters W N n b of Feeders and Ampacity Q � 1 o Lgtpti and Nature of Proposed Electrical Work WIRING OF NEW BOILER �. w( n+Cgn o1 'on of the following table may be waived by the Inspector of Wires. (� I >-- NQ;o ecessed Luminaries No.of Ceil.-Susp.(Paddle)Fans No.of Total C — Transformers KVA Lu j cr 11lo_ii Luminaries Outlets No.of Hot Tubs Generators KVA N .93 Luminaries Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. Batter/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 El Municipal ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water K`�, 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: 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ADVANTAGE ELECTRIC,INC. 77) LIC.NO.:A17183 Licensee: ROGER A.MEDEIROS C-Z2 ..a Signature `J%�- LIC.NO.: E28683 (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: 508-428-1231 Address: 14 Leda Rose Marstons Mills 02648 Alt.Tel.No.:508-326-7921 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee Does not haveThe liability insurance coverage normally Required by law. By my signature below, I hereby waive this requirement. I am the(check ones Owner ❑Owner's agent. Owner/Agent PERMIT FEE: $ SD-Signature Telephone No.