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Home My WebLink AboutBLDE-21-002738 Commonwealth of Official Use Only Ems, 0Massachusetts Permit No. BLDE-21-002738 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:11/13/2020 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 de bed below. Location(Street&Number) 143 ROUTE 6A CA-443c- - A-L.-,A1 Owner or Tenant Telephone > Owner's Address 143 ROUTE 6A,YARMOUTH PORT, MA 02675 i ..*Q Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appr 1; ) it s►/ ' Purpose of Building Utility Authorization No. . t Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Met > New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters- `, Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install exhaust fan,water heater,&receptacle. 44)) 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 grnd. Ig iii. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 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 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 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: STEVEN A SOBY Licensee: Steven A Soby Signature LIC.NO.: 24777 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:22 CLARK ST,YARMOUTH PORT MA 026751811 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: $75.00 143 o (I tle IZ-0 - ''CJ\J°C. 51 ,.. RFCE1VE ® 1„ � � f � � Official Use Only 'E �[.lspartment o��}irs Serviced Permit No. L.. _ `rv_ ; NT 13 u i u i�� u i. Occupancy and Fee Checked f = BARD 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 Codc(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /7-,/1/- d 0 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) /4/3 /Q.yl- /t A. Owner or Tenant 6-4 ;)/ r2,D yji,J Telephone No. r‘, 79 2 6 wq ' 1 Owner's Address /4/ 3 e, )- la 4 Is this permit in conjunction with.a building permit? Yes VNo 0 (Check Appropriate Box) Purpose of Building 5 i we /-,gri I Utility Authorization No. Existing Service AID Amps i,k)/ 4.`j /4olt Overhead Undgrd 0 No.of Meters / • ' New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: 4,0 L c., t , ; .. a' /y"tL� 1..07 2 .4w/4'1• 2 ?r- .f'is G 1o.�/7X ie 1 Completion of the followinKtable may be waived by the Infector of Wires. b No.of Recessed Luminaires No.of Ca.-Snap.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA n -k' No.of Luminaires swimming Pool Above 0 In- ❑ No.of Emergency Lighting umres mmgird. grad. Battery Units `2 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones '' -No.of Detection and . ,-- No.of Switches No.of Gas Burners Initiating Devices l l,-1 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/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Co nicipnnection 0 other, Co 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 TelecommunicationsofDevesor Equivalent y � No.of Devices Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 4.$1),'71 ./ (When required by municipal policy.) Work to Start: //-. 91-,vInspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and/ penalties of perjury,that the information on this application is true and complete FIRM NAME: S7;`t)C'/U <3_�17I 1" t. '�,4 LIC.NO.: ,,i�/ �y 7 Licensee: %/ )/ S ature �--�� C.NO.: C) (If applicable.enter"exempt the license number line) l us.Tel.No.: 4 Sf' 3 7Yy•-e z-, / Address: /J ,.Ji9 /�/C A )r4didt>/A 4.' Alt.TeL No.: •Per M.G.L.c. 147,s.57-61,security work requires Dep t of Public Safety"S"License: Lic.No. , "'-j 1../ 7 7 7 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's a ent. Owner/Agent Telephone No. PERMIT FEE:$ / Signature