HomeMy WebLinkAboutBLDE-23-002437 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-23-002437
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:11/3/2022
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) 21 CHASE GARDEN LN
Owner or Tenant HART KEVIN F Telephone No.
Owner's Address HART CLAIRE M, 21 CHASE GARDEN LN, YARMOUTH PORT, MA 02664
Is this permit in conjunction with a building 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
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 1 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/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 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: EDWARD L MERRY
Licensee: Edward L Merry Signature LIC.NO.: 17137
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 15 CHECKERBERRY LN,W YARMOUTH MA 026733636 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: $50.00
tJf7
Commonwealth of Massachusetts Official Use Only
R F "' D Department of Fire Services Permit No. �3 J7
e `
G =OARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
N[--01/07
••"��• [Rev. 1 (leave blank)
BUILDING DEPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
BY. --�-
-- 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: 11-1-2022
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) 21 Chase Garden Ln,Yarmouth Port
Owner or Tenant Kevin Hart Telephone No. 774-291-01i83
Owner's Address
Is this permit in conjunction with a building permit" Yes 0 No'x❑ (Check Appropriate Box)
Purpose of Building residence Utility Authorization No.
Existing Service 100 Amps 120/240 Volts Overhead❑ Uodgrd❑ No.of Meters 1
New Service Amps Volts Overhead 0 Uodgrd❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Wiring for a 5 zone circulator panel and a Navien boiler,ski breaker
Completion of the_following table may be waived by the lnsyector of Wires.
No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Lighting Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming root Above ❑ la- ❑ No.of Emergency Lighting
grad grad. Battery Units
No.of Receptacle Outlets Na of Oil Barriers 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
No.of Waste Disposers Heat ns Pomp Number To KW No.of Self-Contained
Totab: , Dehtttioa/Alertieg 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 KW No.of No.of Data Wiring:
Haters Signs Ballasts No.of Devices or Equivalent
No.Hydro massage 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.
Estnmued Value of Electrical Work: (When required by municipal policy.)
Work to Start: 10-29-2022 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 El BOND 0 OTHER❑(Specify:) GENERAL COMP.LIABILITY 06242023
(Expiration Date)
I certify,under the pains and penalties of perjury,that the infonmdon on this application is true and complete.
FIRM NAME: Ed Merry Master Electrician Inc. edwardmerry35 gmail.com LIC.NO.:A17137(2145 Al)
Licensee: Ed Merry Signature d/a�/y 7 (1 LIC.NO.: 35745E
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 508-2214335
Address: 15 Checkerberry lane West Yarmouth.Ma.02673 Alt.Tel.No.:
°Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License:here: 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 ❑owner's ant
Owner/Agent
Signature Telephone No. PERMIT FEE:$