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Home My WebLink AboutBLDE-22-004755 co te, Commonwealth of Official Use Only ._ E-. , '. Massachusetts Permit No. BLDE-22-004755 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:2/28/2022 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) 141 BAYVIEW ST Owner or Tenant BYRNE JAMES J Telephone No. Owner's Address BYRNE ERIC, 51 BARBARA RD,WALTHAM, MA 02154 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Rs riate Box) Purpose of Building Utility Authorization No. s Existing Service 100 Amps Volts Overhead 0 Undgrd 0 o o' , • New Service Amps Volts Overhead 0 Undgrd Number of Feeders and Ampacity I Location and Nature of Proposed Electrical Work: Emergency repair for service. P : , , , 4 Completion of the following table may be i e ector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers 0VA No.of Luminaire Outlets No.of Hot Tubs Generators f� KVA Swimmin Pool Above ❑ In- ❑ No.of Emergency Lightii No.of Luminaires g grad. 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 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 0 Municipal ❑ 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 Sites 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: ANDREW M LEVESQUE Licensee: Andrew M Levesque Signature LIC.NO.: 17318 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:461 LOWER COUNTY RD, HARWICH PORT MA 026461831 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $200.00 / At✓ (�rt.Ct e,_9 Tilkto T bo 3// i //f q�q O ia�Use,Only-( S5 Commonweank o f Ma33ackfzett3 . ,'yam, (/ I_`C—[/ 1-* — t c� Permit No W=711'— 2epartment ot ire Seroice3 will'------- , Occupancy and Fee Checked e - L" BOARD OF FIRE PREVENTION REGULATIONS �`� [Rev.1/07] (leave blank) APPLIC I TI I I FOR PERMIT TO PERF•RM ELECT ICal L WORK All work to be performed in accordance with the Massachusetts Electrical Code C), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) late: 2 (0 2 0 2-2-- City or Town of: / t f�/1a/p j/(44- To the In pecto of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work de bed below. f Location(Street&Number) 14-1 Vi t E t V` `te,1 - t'V G 'JQ K M V TT4 Owner or Tenant By Tel phone No. Owner's Address Is this permit in conj nction with a buil2 permit? Yes ❑ No (Check Appropriate Box) Purpose of Building leitIgirikiNUtility uthorization No. E+xihtiug Service i(;1) Amps 134/j,r0Volts Overhead r Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity _ rLocation andOIY Nature of Proposed Electrical Work: E�" ,,N �i , C P. Oc 5 Completion of thefollowin:table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grad ❑ grad. ❑ 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. Tons No.of Alerting Devices No.of Waste Disposers Heat Pins Number Tons KW No.of Self-Contained Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑Other Heating Appliances KW ecurity ystems: No.of Dryers No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lectri al Work: (When required by municipal policy.) Work to Start: 2 I 0 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE GE: 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 IN BOND ❑ OTHER 0 (Specify:) I certify,under the pains andpenalties ofperjury,that the information on this application is true and complete. FIRM NAME:Harwich Port Heating &Cooling, LLC LIC.NO.:17318A Licensee: Andrew Levesque Signature ,i/tp-eiE-- LIC. 359 N0.: 76E (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 359 2-3959 Address: 461 Lower County Rd, Harwich Port, MA 0204+0 • Alt.Tel.No.: *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)❑owner ❑owner's agent. Owner/Agent PERMIT FEE:$ r Signature Telephone No. ** Please fax a copy back to us at 508-; i!y-6075 ** or e-mail to: kecia ,hphcllc.com .df.YAR TOWN OF YARMOUTH e• ' �r BUILDING DEPARTMENT . y 1146 Route 28, South Yarmouth,MA 02664 t SE 508-398-2231 ext. 1263 Fax 508-398-0836 K. Elliott, Inspector of Wires kelliottnyarmouth.ma.us March 1,2022 Andrew Levesque Harwich Port Heating & Cooling, LLC 461 Lower County Road, Harwich Port,MA 02646 Location: James Byrne, 141 Bayview Street,West Yarmouth Permit Number: BLDE-22-004755 Dear Andy, The above noted location inspection failed to pass for the reason(s) listed. Article 230-24(B)(1) Vertical clearance for overhead service conductors. Please forward the required re-inspection fee of eighty dollars ($80.00) to this office and advise when the corrections have been made and when access may be gained, to the property, for the re-inspection. If you have any questions please do not hesitate to contact me. Sincerely, Town of Yarmouth, Building Department K. Elliott, \ ,�1) Inspector of Wires 4 (t)" � ~ I ' The Commonwealth of Massachusetts Department of Industrial Accidents �'hire of Investigations } ' 600 Washington Street Boston,MA 02111 www naass.gov/dia Workers' Compensatio Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organization/Individual): Harwich Port Heating&Cooling LLC Address: 461 Lower County Road City/State/Zip: Harwich Port MA 02646 Phone#: 508-432-3959 Are you an employer?Check the appropriate box: Type of project(required): 1.[ I am a employer with 65 4. [] I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. 2.New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [2'Remodeling These sub-contractors have ship and have no employees 8. Demolition working for me in any capacity. employees and have workers' 9 Buildingaddition [No workers'comp.insurance comp.insurance t `� required.] 5. ❑ We are a corporation and its 10.2 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.2 Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c.152,§1(4),and we have no 13.�Other HVAC employees.[No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. lithe sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Selective Insurance Company of South Carolina Policy#or Self-ins. Liicc..#: WC9059813 1 '/� ) Expiration Date: 1�0/26/2021 / Job Site Address: / "1 1 `b I " l ' City/State/Zip:p 1 V. A(V i vi Ci /State/Zi : � Attach a copy of the workers'com nation policy declaration page(showing the policy number a expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert j under t ie ' and pelu1lties of perjury that the information provided a o e is tr e and correct. Signature: Date: Phone#: 508-432-3959 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# it Issuing Authority(circle one): II 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: II