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Home My WebLink AboutBlde-20-001858 i. V CifCommonwealth of Official Use Only E00 Massachusetts Permit No. BLDE-20-001858 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:10/7/2019 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 describedpelow.r/ .... tti/�Location(Street&Number) 17 MAYFLOWER RD / � " Il Il (/ ~/Owner or Tenant LAURO CLAIRE G TR telephone VO Owner's Address LAURO REALTY TRUST,201 WEATHERLY DR, SALEM, MA 01970-6640 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 furnace. 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 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 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 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: SEAN C ROGAN Licensee: Sean C Rogan Signature LIC.NO.: 20141 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 MELIX AVE, PLYMOUTH MA 023601280 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 N7/ tgi 6c M_ Commoruasa g. �j / I. -_-_ o�///a.�arh�.cafft • Official Use Only _ _ �� 1Jsparfnsa+sE o{`firs�arvicet Permit No. &i1.4•- ,Fj5� BOARD OF FIRE PREVENTION REGULATIONS Occupancy 1/07) and Fee Checked [Rev. IV] eave blank> _ APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK . All work to be performed in accordance with the Massachusetts ElectricafCode(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIOI7 Date: /'/4 Cg City or Town of: YARNIOUTH To the Inspector of Wires: 1 By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street Jr Number) /.17 *4V i 4241.ei r Z kL Owner or Tenant /=`e.f_`L) L_A,Jl0 Telephone No. V Owner's Address S,0/t G J = J Is this permit in conjunction with a building permit? Yes Purpose of Building ✓�L✓L///� No (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead 0 Un dgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Und grd Number of Feeders and Ampacity ❑ No.of Meters Location and Nature of Proposed Electrical Work: /Mallet .4v//'.4C.e Completion of the following table may be waived by the Inspector of Worms. No.of Recessed Luminaires No.of Cal.Susp.(Paddle)Fans No.of Total No.of Laminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of 1�:mergency Lighting grad. _mid. � Batterq Unite Na.of Receptacle Outlets No.of Ott Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges - Initiating Devices No.of Air Cond. To Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW' Local❑ Municipal No.of D era Connection ❑ �� ' Heating Appliances , ecarity Systems:" o.of ater No.of Devices or E • _lent Heaters KW °'° o.of Data Wiring: Si s Ballasts No.of D ices or uivalent No.Hydromassage BathtubsMotors elecomf Devi e o r Wiring; Total HP No.of Devices or it eat OTHER 1� C Estimated Value of Electrical Word Attach additional detail if desired or as required by the Inspector of Wires. (WhenWork to Start: ��/.y��j�j -- (Whenrimed by municipal policy.) ® 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 fatless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial t� undersigned certifies that such cover_ a is in force,and has exhibited proof of same to the permit issuing office. � ,�� equivalent. The CHECK ONE: INSURANCE IIQ BOND 0 OTHER Q I cet•tify, under the pains and penalties v a 0 (Specify:) FIRM NAME: S C/� 7. . p1 that the information on this application is true and completes Licensee: / c �� y LIC.NO.: �L¢L (If applicable,enter"exempt' Signature LIC.NO.:,�$ i the h ease number line) Address: 3� rht�'y zL .A,�/hl ,,,�® Bus.Tel.No.: s.57-61 �,.., oz s'M j Per M.G.L.c 147, / Q OWNER'S INSURANCE WAIVER: or requires 1, „— Alt.Tel.No. Department of Public Safety S^License: Lic.No. I am aware that the Licensee does not have the liability insurance coverage a n�� Orequired by law./Agent By my signature below,I hereby waive this requirement. I am the(check one owner B tmally t Signature _. El