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Home My WebLink AboutBlde-20-002330 D Official Use Only or F v.Commonwealth of Fi.. ,, 0° Massachusetts Permit No. BLDE-20-002330 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:10/24/2019 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 elow. Qy� Location(Street&Number) 24 PHYLLIS DR 7E- 7- o�► 3p Owner or Tenant KELLY JOSHUA D Telephone No. Owner's Address DONOVAN EMILY A, 24 PHYLLIS DR, 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 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 TotalTransformers 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 ❑ (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: $200.00 ‘QIIIA ( 94S-i( et c. -- gA ,-- �= Cam ma,wsatth off Ma6.6a.chuseits • Official Use Only 3. at =/ 1Jeparfineni o .7-re Jervice6 Permit No. .O- 23�Q ___Ij_- _' / --- ` BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked �f {Rev. l/07] (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.DD (PLEASE PRINT IN INK OR TYPE ALL INFORMATIOI 9 Date: /i_f , / ByCity or Town of: YARMOUTH To the Inspector of Wires: this application the Imdersigned gives 'ce o is or her intention to perform the electrical work described below. Location (Street&Number) Owner or Tenant Telephone No. Z-10 - Owner's Address .5 Is this permit in conjunction wi ukaLr/ Yes ❑ No Check Purpose of BuildingSV � � ( Appropriate Box) /� //l Utility Authorization No. Existing Service Amps / Volts Overhead ❑. Undgrd ❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Lo 'on and Nature of Proposed Electrical Work: / _ _ i Completion of thefollowingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cei1.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA J No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Lmergency Lighting erred. grnd. Battery Drills 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. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals:1 Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal Local❑Connection ❑ Omer No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of Heaters ' No. of 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 derail if desired or as required by the Inspector of Fires. Estimated Value of Electrical Work C� (When required by municipal policy.) Work to Start: �4p/ ... 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 unl the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent a-chess undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE liejl, BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penaltie of perjury that the information on this application is true and complete. FIRM NAME: 1 lr/, LIC.NO.: Licensee: Signature (If applicable,enter""ex cLIC.NO.: emp "'' tense�m�ybf line.) ✓ . Address: 66 (, f c (>hoi � __/),„;) d j Alt Tel.No.: j Per M.G.L. c. 147,s. 7-61,securitywork requires TeL No.: Department of Public Safety 'S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally requiredrequired by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent Owner/Agent il' Signature Telephone No. I PERMIT FEE: S