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Home My WebLink AboutBLDE-21-006485 a `• Commonwealth of Official Use Only ilt Massachusetts Permit No. BLDE-21-006485 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:5/10/2021 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) 184 SOUTH SEA AVE UNIT 31 Owner or Tenant KANE MICHAEL W TRS Telephone No. Owner's Address 5 SCHOOL ST, MEDWAY, MA 02053 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 gNo.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 water heater&distribution panel. 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 nd. ❑ Ig ❑ No.of Emergency Lighting Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I 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 AlertingDevices Tons No.of Waste Disposers . Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑ Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters 1 KW No.of No.of Data Wiring: Signs Ballasts No.of Devics 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: Robert F Davis Licensee: Robert F Davis Signature (If applicable,enter"exempt"in the license number line.) Tel. NO.: 32671 Address:24 COOPER DR, FRANKLIN MA 020381069 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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. I PERMIT FEE: $75.00 I al eil S,. I l U ('Z( L gr ,, s w, Commonwealth oi///aedachiueetta `l c it- t cc�� nn Official Use Only • ''f F Zspartnumi o1 gips ServUsd Permit N0. � c� —(�(� �� BOARD OF FIRE PREVENTION REGULATIONS >` Occupancy and Fee Checked APPLICATION FOR PERMIT TO PERFORMRev. 1/o7� leave blank ---- All work to be performed in accordance with the Massachusetts ELECTRICAL WORK o (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) � City or Town of: YARMOUTHDate: ,,,� Y. 2 By this application the undersigned gives notice of his or her intention to perform the electrical work described To the Inspector o Wires: t Location(Street&Number) / below Owner or Tenant spt,,� N�� 3 / 'S'O�y S�4 i/F Owner's Address f/ A/L F S T Telephone No. 7 -2/p_Q s`� 141 1 Is this permit In conjunction with a building permit? Purpose of Building eS flaAl e Yes ❑ No & (Check Appropriate Box) (f Existing Service/0 Utility Authorization No. `� O Amps / Volts - -- Overhead S Undgrd❑ No.of Meters — _ New rvlce Amps / Volts Overhead❑ Undgrd E Number of Feeders and Ampacity 0 No.of Meters _ Location and Nature of Proposed Electrical Work: vl vi No.of Recessed Luminaires Completion o the ollowin, table m be waived b the/nsiector o Wires. `U.. No.of Ceii:Sus '�'f No.of Luminaire Outlets p•(Paddle)Fans o•o KVA 4` No.of Hot Tubs Transformers ,t' No.of Luminaires Generators KVA Swimming Pool ,rnd.e ❑ and. ❑ 'o.o mergency g ng No.of Receptacle Outlets $atte Units No.of Oil Burners • ` No.of Switches FIRE ALARMS No.of Zones No.of Gas Burners `o.o t etec on an No.of Ranges Initiatin_ Devices No.of Mr Cond. ota • No.of Waste Disposers 'eat ' Tons No.of Alerting Devices ump 'umber • �� Totals: ............_...._._....... No.of Dishwashers ..op!...._ `o.o e - onta ne Detection/Alertin, Devices Space/Area Heating Key LocalDryers 0 'un etpa Heating Appliances Connection ❑ �� `o.o "a er t KW ecu ty ystems: Heaters ` vas KW o.o 'o o No.of Devices or E•uivalent No.Hyd He assage Bathtubs Si,as Ballasts Data Wiring: No.of Motors No.of Devices or E•uivalent OAR: ��5 Total HP a ecommun ca'ons s* r ,g /�/c,gt L Aaq't�i�� No.of Devices or E•uivalent Estimated Value of Elec 'cal Work: �.7.—p A, Ga Attach additional detail if desired,or as required by the Inspector of Wires. to Start:S'/ ,� (When required by municipal policy.) WorkSURANCE COVE ( Inspections to be requested in accordance with MEC Rule 10, RAGE: Unless waived by the owner,no permit for the performance of electrical work mayissue the licensee provides proof of liability insurance including"completedand upon completion. undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing Ae unless operation"coverage or its substantial equivalent. The CHECK ONE: INSURANCE I certify,under the pains n penaltiesBON D 0 OTHER 0 (Specify:) office. FIRM NAME: fperl`ury,that the information or:this application is true and complete. Licensee: Rp 64R�- F DA/LS (Ifapplicable nt r Signature LIC.NO.: Address: "exempt" 1rcQ�e number line.) LIC.NO.:Lc___: - *Per M.G.L.c. 147,s.57-61,securitywork7 �N �� 03 Bus.Tel.No.:bl7 INS RANGE requires De Alt.Tel. o..----------- OWNER'S y� w b6" WAIVER: parhnent of Public Safety"S"License: Owner/Agent gy lawI am aware that the Licensee does not have the liability insurance coverage n y sign a below,I hereby waive this requirement. I amLic.No. Owner/Agent Signature the(check one / owner Y Telephone No 77 : /(� �}Rf owner's a:ent. Lli PERMIT FEE:$ UQ