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Home My WebLink AboutBLDE-19-001016 vi or Use Only or Commonwealth of ics Massachusetts Permit No. BLDE-19-001016 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked f Rev.1/071 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 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 RD UNIT 38 Owner or Tenant KAUFMANN JACK Telephone No. Owner's Address KAUFMANN ROSALYN,300 BUCK ISLAND ROAD 3-8,WEST YARMOUTH,MA 02673 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd Cl No.of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement panel(UNIT 3-B) 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 0 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 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 i 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 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: 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,Bamstable 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 & aqtie � pp(plYi C.ommonwaant yy�of///amaakaeffa Car Use Only "wi= 2.parfmanl o`Jin Jarvtcaa Permit No. J`? BOARD OF FIRE PREVENTION REGULATIONSOccupancy andFeeChk)ked [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 3B Map Parcel# 1 Owner or Tenant Telephone No. J�j Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) ArGPurpose of Building Utility Authorization No. /.1 ) Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters �-Si, New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Ca t '`lumber of Feeders and Ampacity LE!9 co Ili: dcdhon and Nature of Proposed Electrical Work: REPLACE FPE PANEL WITH NEW SQUARE D PANEL .5 N Ill ll Completion of the following table m be waived by the Inspector of Wires. 17„ t''' al I No4nf Recessed Luminaires No.of Ceil:Sus .(Paddle)Fans No.of Total P Transformers KVA ! ctj NoJlof Luminaire Outlets No.of Hot Tubs Generators KVA I ( � y Above In- No.of Emergency Lighting t„__ � No.�of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units NoJof Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No. Initiaattingon of Dand ng Devices Tot 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 Municipal No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other No.of Dryers Heating Appliances KW Secu oSystems:* f 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 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: 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: R&S LaFleur, LLc LIC.NO.: 16814A Licensee: Raymond E. LaFleur Signatur % IC.NO.: 15875E (Ifapplicable,enter "exempt"in the license number line.) (!// /�j Bus.Tel.No: 150815675E 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 0 owner's agent. Owner/Agent I PERMIT FEE: $ 50.00 Signature _Telephone No. *IMPORTANT:A separate permit is required for the installation of smoke detectors.Fire Alarm inspections are performed by the FD having jurisdiction.