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Home My WebLink AboutBLDE-23-003500 .......... Commonwealth of Official Use Only L r Massachusetts Permit No. BLDE-23-003500 �� 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:12/27/2022 City or Town of: YARMOUTH To the Inspector of Wire s.• By this application the undersigned gives notice of his or her intention to perfo the_electrical wor d eri ed e w. 1/4 Location(Street&Number) 22 WHITES PATH L I`� r� Owner or Tenant Telephone No. Owner's Address D,41,4Eidf8RT rcrAL iY 664 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 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Demo and misc electrical 1st&2nd floors. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 6 No.of Total Transformers KVA No.of Luminaire Outlets 40 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting 8 grnd. grnd. Battery Units No.of Receptacle Outlets 30 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 10 No.of Gas Burners No.of Detection and 6 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water 2 KW 4 No.of 1 No.of Ballasts 1 Data Wiring: 30 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: 12/27/2022 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: Licensee: Jon T Moreau Signature LIC.NO.: 22967 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:9 Redberry lane, MARSTONS MILLS Ma 02648 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: $225.00 Cotnmonwoatth _/Maddadiadettd Official Use Only G� >il r„ apartment L '7 Permit No. EZ3 - 3500 s a partment o f giro serviced t;-- :' Occupancy and Fee Checked 8 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) 6 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: 12/22/2022 tki 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) 22 Whites Path i Owner or Tenant 22 Whites Path LLC Telephone No. Go Owner's Address 21 L Fruean Ave S. Yarmouth MA 02664 I. Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Corn m e rci a 1 Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity ..li Location and Nature of Proposed Electrical Work: Remove All Electrical On First Floor(Branch Circuits). Install New Lighting/Receptacles On First Floor.Second Floor Remove All Unused Wiring (Data/Phone).Replace Switches, Receptacles, Light Fixtures. ) Completion of the followingtable may be waived by the Inspector of Wires. 1/4tv No.of Total t.b No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans 6 Transformers KVA CI No.of Luminaire Outlets 40 No.of Hot Tubs Generators KVA d; No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting 8 grnd. grnd. Battery Units No.of Receptacle Outlets 30 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 10 No.of Gas Burners -Na.Initiating Devices 6 I tI 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 P� Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Monneunicipalctio n ❑ Other, No.of Dryers Heating Appliances KW SecNo o Systems:* Devices or Equivalent No.of Witter No.of No.of Data Wiring: Heaters 2 KW 4 Signs 1 Ballasts 1 No.of Devices or communications EWquivaglent 30 No.Hydromassage Bathtubs No.of Motors Total HP Tel 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: 12/27/2022 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 VS 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: Coastal Mechanical LIC.NO.: 22967-A Licensee: Jon T Moreau Signature ),erL -4 LIC.NO.: 8082 Al (If applicable,enter"exempt"in the license number line) a Bus.Tel.No.•508-737-8747 Address: 21 L Fruean Ave S. Yarmouth MA 02664 Alt.TeL No.:508-326-9699 *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 0 owner's agent. Owner/Agent PERMIT FEE:$ 225.00 Signature Telephone No. Ate'®R1) - CER IIHCATE OF LIA OLLIITY IINSU NCCE .2i15/2021 THIS CEi41IFICAT.IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIEIC'FE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT; If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). _ . CONTACT Tina Reeves PRODUCER NAME: Dowling&O'Neil Insurance Agency {A TONE (800)640-1620 FAX No): {AfO,No,Eat): E-MAIL treeves@doins.com 973 Iyannough Road ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC II Hyannis MA 02601 Hartford Underwriters Ins Co 30104 INSURERA: INSURED INSURER B Safety Indemnity Insurance Company 33618 Coastal Plumbing&Heating LLC lld5Uft€P,C: Hartford ins Company of the Midwest 37478 211 Fruean Way INSURER D: INSURER s: ; South Yarmouth MA 02664 1690 j INSURER F: — --- CL211214934B9 REVISION NUMBER: COVE32A�C.9r'=S CERTIFICATE NUMBER: -- - - 2— THIS IS TO CERTIF;'THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ' INDICATED- NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTA: TYPEflrifiSURANCE I1d5D RIJD,A.DULSu8Rii POLICYEXF POLICYEXP ' LIMITS 31�SR POLICY NUMBER (MMIDDIVYYY) Il�f�IJDPfYYYI a 1,DOO,ODfl XI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED 1,000,000 i CLAIMS-MADE 1 XI OCCUR :PREMISES(Ea occurrence) $ i LIED EXP(Any one person) $ 10,000 A •• ' DBSBAAJ7RXH 12/31/2021 12/31/2022 1,000,000 PERSONAL , ,$ 2 DDO ODO GEI fLAGGREGATE L1MlTAPPLIES PER: GENERALAGGREGATE i4 2,OOO,fl POLICY I I JECOT I 1 I LOO OD ;PAODUCTS-COMP/OPAGG $ OTHER: • COMBINED SINGLE LIMIT $ 1,000,000 AUTOMOBILE LIABIL!T Y (Ea accident) • BODILY INJURY(Per person) $ ANY AUTO . OWNED v SCHEDULED 5915690 12/31/2021 12/31/2022 BODILY INJURY.(Per accident) $ B AUTOS ONLY AUTOS PROPERTY DAMAGE $ ',.r HIRED � NON-OWNED accident) 4/.'N AUTOS ONLY '"^ AUTOS ONLY I$ UMBRELLALIABI OCCUR EfiCHOCCURP.ENG ($ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED j RETENTION$ ,�I WORKERS COMPENSATION XI 5 A UTE I I 0TH_ AND EMPLOYERS'LIABILITY YIN • E,L.EACH ACCIDENT I$ 1,000,000 ANYPROPRIETORJPARTNERIEXECUTNE N ,'NtA 08WECAJ7RT4 12/31/2021 12/31/2022 1,000000 C .OFFICERIMEMHEROCCLUDED? EL DISEASE EMPLOYEE $ describeMandatory in NH) p,L DISEASE-POLlCYLItil1T $ 1,000,000 If E under DESCRIPTION OF OPERATIONS belov� 1 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 1191,Additional Remarks Schedule,may be attached if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements,Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended thecoverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION LATION M SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Yarmouth �.,� Town Hall;1146 Route 134 AUTHORIZED REPRESENTATIVE • I AA 02664 .-_ -� ---- -c-„- ��`ra, South Yarmouth - I O 1983-20155 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD