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Home My WebLink AboutBlde-22-002830 \,/ ` Commonwealth of Official Use Only . ,t Massachusetts Permit No. BLDE-22-002830 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:11/16/2021 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) 212 BLUE ROCK RD Owner or Tenant WOODS THOMAS E Telephone No. Owner's Address WOODS DOROTHY A, 1262 RANDOLPH AVE, MILTON, MA 02186 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 KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting rnd. rnd. 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent 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: Licensee: Jon T Moreau Signature LIC.NO.: 22967 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:9 Redberry lane, MARSTONS MILLS Ma 02648 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 my signature below,I hereby waive this requirement.I am the(check one) 0 owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 kl{( 1r Commonwealth of Massachusetts Official Use Only 22 0.* t, Permit No. 6ZZ ✓Co_ - Department of Fire Services 4 = I�_ Occupancy and Fee Checked U!' i>'�.,,• -`--- BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (leave blank) .F cm rY "AA' Z '`? ' PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK IL t ,_, All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (., o ;IP', ASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 11/10/2021 w i° , City or Town of: South Yarmouth To the Inspector of Wires: re _,_, jiy is application the undersigned gives notice of his or her intention to perform the electrical work described below. ___ l.o ation(Street&Number) 212 Blue Rock Road Owner or Tenant Tom and Dolly Woods Telephone No. Owner's Address 1262 Randolph Ave - Milton, MA 02186 Is this permit in conjunction with a building permit? Yes ❑ No [' (Check Appropriate Box) 5 Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters c) New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters cJ Number of Feeders and Ampacity —S Location and Nature of Proposed Electrical Work: Replace Gas Furnace Completion of the followingtable may be waived by the Inspector of Wires. c/' 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 SwimmingPool 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. Tansl No.of Alerting Devices _ No.of Waste Disposers Heat Pump Number -. Tons KW No.of Self-Contained ..3,_ Totals: Alerting No.of Dishwashers Space/Area Heating KW Local 0 Detection/MDunicipal Devi❑ces Cnn No.of Dryers Heating Appliances KW Security syostemections:* i No.of Water KW No.of No.of No.of Data Wiring: evces or Equivalent 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: 750.00 (When required by municipal policy.) Work to Start: ASAP 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 coy yage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 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: Coastal Mechanical LIC.NO.: 22967-A Licensee: Jon Moreau Signature At-7/14zo0v LIC.NO.: 8082A (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: 508-737-8747 Address: 21 L Fruean Ave - South Yarmouth. MA 2664 Alt.Tel.No.: 508-326-9699 *Security System Contractor License required for this work;if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ f -