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HomeMy WebLinkAboutBLDE-19-1100 oz Commonwealth of%,,,, OfsaalUseOnly Massachusetts Permit No. BLDE-19-001100 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.I/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 ININK OR TYPE ALL INFORMATION) Date:8/22/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to permrm the electric orksly`nbe below. Location(Street&Number) 40 CROSBY ST EXT V � Owner or Tenant GREENE MARJORIE J TR(EST OF) Telephone No. Owner's Address GREENE DRAGON RLTY TRUST,40 CROSBY ST EXT,SOUTH YARMOUTH, MA 02664 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 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead CI Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Security 8 fire system installation. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell: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- a No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 2 No.of Switches No.of Gas Burners No.of Detection and 16 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons I 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 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: 1 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 ❑ (Specify:) I cent)",under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Robert K Boucher Licensee: Robert K Boucher Signature LIC.NO.: 1317 (if applicable,enter"exempt"In the license number line.) Bus.Tel.No.: Address:218 SETUCKET RD,YARMOUTH PORT MA 026752258 Mt.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 Cl owner's agent. Owner/Agent ' Signature Telephone No. PERMIT FEE:$45.00 I i_ g( l Ie Lmcitt- wit -owur J Q/(2/te c, t Commonwealth of Massachusetts Official Onl co €ryp Permit No. ; _;.+i Department of Fire Services "�� Occupancy and Fee Checked `;,. c BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (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 ALLINFORMATIOIt9 Date: 8/21/18 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) 40 Crosby Street,South Yarmouth Owner or Tenant Luke Residence Telephone No. Owner's Address Same Is this permit in conjunction with a building permit? Yes X No (Check Appropriate Box) Purpose of Building Utility Authorization No. iExisting 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 ©X-71'1:-Loca ion and Nature of Proposed Electrical Work: Security and fire alarm in new construction. ww I Completion of the following.table may be waived by the Inspector of Wires. uj ' J No.! f Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No,of Total � � Transformers KVA `) No 1 f Luminaire Outlets No.of Hot Tubs GeneratorsKVA i ,,v ¢ No!bf Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting a grnd. grnd. Battery Units 41 Al-o.lo1Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 2 J No.of Detection and No.of Switches No.of Gas Burners Initiating Devices 16 No.of Ranges No.of Air Cond. TORI No.of AlertingDevices 16 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 Loll 0 Municipal 0 Omer Connection No.of Dryers Heating Appliances KW Security Systems:* Na of Devices or Equivalent No.of WaterKµ, No.of No.of Data Wiring: Heaters Signs Ballasts Na of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:al1 No.of Devices or Equivalent OTHER: Attach additional detail if desire4 or as required by the Inspector of Wires. Estimated Value of Electrical Work: 6k (When required by municipal policy.) Work to Start: 8/20/18 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 X BOND 9 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Seaside Alarms inc LIC.NO.: 1317C Robert Robert K.Boucher Signature 1/ LIC.NO.: (ifapplicable,enter "exempt"in the license number line) Bus.Tel.No.• StlR-194-0599 Address: 1265 Route 28,South Yarmouth,MA 02664 Alt.Tel.No.: *Security System Contractor License required for this work;if app'cable,enter the license number here: S-0046 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/AgentPERMIT FEE:$ SignatureTelephone No.