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HomeMy WebLinkAboutBLDE-19-001017 „ Commonwealth of Official Use Only /SA Massachusetts Permit No. BLDE-19-001017 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked f Rev.l/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:8/21/2018 City or Town of: YARMOUTH To the Inspector of Wrres: By this application the undersigned gives notice of his or her intention to perlonn the electrical work described below. Location(Street&Number) 300 BUCK ISLAND RD UNIT 5C Owner or Tenant GOLDBERG JOSEPH TR Telephone No. Owner's Address GOLDBERG PAULINE E,300 BUCK ISLAND RD UNIT 5D,WEST YARMOUTH,MA 02673 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 panel(UNIT 5-D) 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 I No.of Zones No.of Switches No.of Gas Burners No.of Detection and _ Initiation Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tont 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 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 Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total IIP 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 terrify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: RAYMOND E LAFLEUR Licensee: Raymond E Lafleur Signature LIC.NO.: 16814 (if applicable,enter"exempt'in the license number line.) Bus.Tel.No.: Address:355 Old Jail Ln,PO BOX 253,Barnstabie MA 026301426 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:$50.00 Dice 1"1 iglat • � � o/ � Official Use Only `N :j' t ry /c7 n Permit No.�� -♦/© 1 ->aii�S �[J�arinunE of Jw JirvicM ` `� Occupancy and Fee Checked BOARD 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 Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 8/15/2018 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) 300 BUCK ISLAND ROAD-UNIT 5D Map Parcel# Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. N� Existing Service Amps / Volts Overhead El 0 No.of Meters s� New Service Amps / Volts Overhead 0 Undgrd ❑ No.of Meters e �� Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: REPLACE FPE PANEL WITH NEW SQUARE D PANEL a'.�. --_,I1 Completion ojthe following table may be waived by the Inspector of Wires. L'' m ir f Recessed Luminaires No.of Ceil:Sus addle Fans No.of Total P(P ) Transformers KVA N No1rot Luminaire Outlets No.of Hot Tubs Generators KVA Ili c5) off of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units :) I t of of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones LU ¢ No.of Detection and Nd of Switches No.of Gas Burners Initiating Devices NOj of Ranges No.of Air Cond. Tonal 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 HeatingKW Local❑ Municipal ❑ Other P Cyonnection No.of Dryers Heating Appliances I{µ Security Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Tel No.of Devices or Equivalent OTHER: Attach additional detail rjdesired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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 (a BOND ❑ OTHER ❑ (Specify:) 1 certify,under the pains and penalties of perjury,that the information on this application is true and complete FIRM NAME: R&S LaFleur,LLc et. LIC.NO.: 18814E Licensee: Raymond E. LaFleur Signetur45:pi� C.NO.: 15875E (Ifapplicable,enter"exempt"in the license number line) Bus.Tel.No.. (5081775-6814 Address: 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)0 owner ❑owner's agent. Owner/Agent PERMIT FEE: $ 50.00 Signature Telephone No. •IMPORTANT:A separate permit is required for the installation of smoke detectors.Fre Alarm inspections are performed by the ED having jurisdiction.