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Home My WebLink AboutE-19-1015 or Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-001015 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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: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 1 C Owner or Tenant PRUCHNICKI RONALD W JR Telephone No. Owner's Address LOMBARDO CARRIE,277 PARK AVE,NAUGATUCK,CT 06770 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 1-G) 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 Arbde ❑ gnd. ❑ No.of Emergency Lighting g 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. Total No,of Alerting Devices Tons No.of Waste Disposers Heat Pump Number I 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 Slens 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 ofperJury,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,Barnstable 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) ❑ owner 0 owner's agent. Owner/Agent Signature 4 Telephone No. PERMIT FEE:$50.00 Cee Y �\ //�� R' Ny1 // l.ommanweattk o`///alsachadt l O m Use Only o f A�/ 'a !t ipsc� c7 �7 Permit No. &(`.- 1 S (� - 47 0 �' Thvar!'nunf o`Jw Sias U c !1�I I( y 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 1G 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. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters _ �J(�`V \ New Service Amps / Overhead❑ Undgrd El No.of Meters tyYNumber of Feeders and Ampacity r�l��l Location and Nature of Proposed Electrical Work:Volts REPLACE FPE PANEL WITH NEW SQUARE D PANEL — 0 iwi -�: 11 Completion of the following table may be waived by the Inspector of Wires. r o 3i NH.of Recessed LuminairesC11 i No.of Ceil:Sus addle Fans No.of Total P (P ) Transformers KVA O it,. N, .of Luminaire Outletsil No.of Hot Tubs Generators Total!ij c. Above In- No.of Emergency Lighting �� l� .of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units al ¢ c Ni L.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 fottPump Number Tons KW No.of Self-Contained als: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Local❑ ❑ other P MunicipalConnection No.of Dryers Heating Appliances KW SecuritySystems:* vDevicesstems:or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Egquivallent 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 2 BOND 0 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 �LIC.NO.: 16814A Licensee: Raymond E. LaFleur Signaturo�//CQJ?,- t� LIC.NO.: 15675E �// (ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.- t5nA1775-8874 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 PERMIT FEE: $ 50.00 Signaturetura Telephone Na. 'IMPORTANT:A separate permit is required for the installation of smoke detectors.Fire Alarm inspections are performed by the FD having jurisdiction.