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Home My WebLink AboutBLDE-22-002329 w \15b Commonwealth of Official Use Only # Massachusetts Permit No. BLDE-22-002329 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:10/22/2021 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) 39 CAPT STANLEY RD Owner or Tenant WOJDYLAK EDWARD A LIFE EST Telephone No. Owner's Address Cl" ,,;.„ -'x,,39 CAPTAIN STANLEY RD, SOUTH YARMOUTH, MA 02664 Is this permit in conjun i n r $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&relays. 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 ElIn- ❑ 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. Total n No.of Alerting Devices 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 ❑ 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 Ballasts Data Wiring: Heaters Siens 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: A J PULLEY Licensee: A J Pulley Signature LIC.NO.: 21843 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:289 QUAKER MEETING HOUSE,RD,E SANDWICH MA 025371366 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(cheek one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 =: 0 l1,44(2, e.f. Cn ommonweank o`91i7a6.4achidath Official Use Onl 2, G * —t ccy�� c7 Permit No. 2t—� ✓ z� W M' ' .(J artmant o gip*Servica3 m == ef� 1_ Occupancy and Fee Checked n„, -,A' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) 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: inb.2.,2.I City or Town of: A,2vt.t.0OM To the Inspector of Wires: By this application the undersigned g es notice of his or her intention to perform the electrical work described below. Location(Street&Number) 3 S (Apr 14I J StkAiL..61 Owner or Tenant Itil,,ct iQ,�./N 11 Live,l,,t,2,6 Telephone No. (2) M Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No 0- (Check Appropriate Box) 4. Purpose of Building i2,c, .T,,,,,._ 7,.,,e-,_,_„may Utility Authorization No. /vVA•. Existing5ervice Amps /_ _ Volts _ Overhead f _ Undgrd _No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: W,ac Re- 4,6)„,. /apt t-E2 s /?t/PLA4 fz) GRcJut 702 2r:t.ii,/5. Completion of the following table may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tof Traa onKVAsformers KVA 1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA AboveIn- No.of Emergency Lighting �, No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units • No.of Receptacle Outlets O No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches O No.of Gas Burners t Initiating Devices Tota<V No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • 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❑ Municipal ❑ other vt Connection • No.of Dryers Heating Appliances KW Security Systems:* JtNo.of Devices or Equivalent j No.of Water KW 'No.of No.of Data Wiring: Heaters Ballasts '3 Signs No.of Devices or Equivcommunications alent ▪ No.Hydromassage Bathtubs No.of Motors ( ) Total HP ,0 Tel No.of Devices or Equivalent Z OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. O v Estimated Value of Electri al Work: (When required by municipal policy.) Work to Start: t0/z.1/Zl Inspections to be requested in accordance with MEC Rule 10,and upon completion. i. 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 ill undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [[Er 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: l 4A-tL Of ()hS oho i1 Et-ere/C- LIC.NO.: Licensee: A 3 1'ULca: Signature /�,— LIC.NO.:42)X'/3 (If applicable,enter"exempt"i license number line.) ✓r Bus.Tel.No.: S[4-39/ geY31 Address: N3 C 121-r 13'`{ Se o fN lbE'n>ty tS tnA.4 . Alt.Tel.No.: 'K too *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 have the liability insurance coverage normally required by law. By my 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: $