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Home My WebLink AboutBLDE-23-001839 noi Commonwealth of Official Use Only Rl% Massachusetts Permit No. BLDE-23-001839 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:10/6/2022 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) 534 WINSLOW GRAY RD Owner or Tenant YARMOUTH HOUSING AUTHORITY Telephone No. Owner's Address 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Disconnect/re-connect to replace 125 amp circuit breaker. 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. grnd. 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. Tootal No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 Ballasts Data Wiring: Heaters Signs 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 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: $160.00 (^tbk ei„...... a �r - -► R E C E,._ . ..E. ° OCT 0 6Mae ea o` aaeac�uaaEfd Official Use Onl :ic7n � � :�, nt o1.}irs Jirvicse Permit No. 11 ;ti ILDii\1G DEPART , !r ' ''d = .. "EVNTION REGULATIONS Occupancy and Fee Checked [Rev. I/071 (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: /i% j�. a,� City or Town of: YARMOUTH To the Ins ectdr of Wires: By this application the undersigned gives notice of his or her intention to perform the elftctrical work described below. Location(Street&Number) 5-''54/ k'1,e1.›.l�'°/ cry—^if y Owner or Tenant ►ffild.m/Dt,9"—A � !,! Owner's Address �' fl»2� Telephone No. �1'y.�251-j Is this permit in conjunction junction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ,.,/' ❑ Undgrd L[.�" No.of Meters New Service Amps / Volts Overhead Number of Feeders and Ampacity 0 Undgrd 0 No.of Meters Location and Nature of Proposed Electrical Work: k> /o 4'4/3,171 c2(1:::, to LigCompletion of thefoilowing.table mm,be waived by the',vector of Wires. No.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fans No.of i No.of Luminaire OutletsTransformers KVA rzx No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- No.of ll mergency Ltgdting .,,1 end• Srtrd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS lNo.of Zones 4. No.of Switches No.of Gas Burners 'No.of Detection and IV No.of Rangestal Initiadns Devices No.Sio�'Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons I.KW No.of Self-Contained Totals:I "" .�"".`-- 1 -- - Detection/Alerting Devlces No.of Dishwashers Space/Area Heating KW Local❑ Municip No.of 1) era Connection 0 �' ry Heating Appliances gW u ty ystems: icho.o Heaters I{W o.a o,o No.of Devices or uivalent Data Winn . No.Hydro massage Bathtubs S s Ballasts No.of Devi or uivalent massag No.of Motors Total HP e ecommun a ons gg OTHER; No.of Devices or E uivatent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work to Stan: (When required by municipal policy.) 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 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 o ��) FIRM NAME: ee(perjury,that the Information on this d�plicatton is true and complete. Licensee: /`j Ij `�� LIC.NO,: � 77 (If applicable, tom,�►r• 'examqt"1n/h licens Signature IC.NO.: �/ Address: v< I //94 r bar line.) -` *Per M.G.L.c. 147,s.57-61,security work sus.TeL No.• ,p�yvy OWNER'S INSURANCE WAIVER: I am a Alt.TeL No.: Department of Public fety"S"License: Lic.No. required by law. By my signature below,I hereby waive this Licensee does tI am the(check one ot have the liability insurance nee coverage no's a:e Owner/Agent ■ owner's a:ent. Signature Telephone No. PERMIT FEE:$ �._J -"M1