HomeMy WebLinkAboutBLDE-19-1916 Vo`/
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Commonwealth of Official Use Only
( ar : Massachusetts Permit No. BLDE-19-001916
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
jRev.1/07j
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 INFORMATIOM Date:10/2/2018
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice othis or her intention to perform aelecinca(work described below.
Location(Street&Number) 3 ST ANDREWS WAY
Owner or Tenant FLAHERTY MARGARET M Telephone No.
Owner's Address 3 ST ANDREWS WAY,SOUTH YARMOUTH, MA 02664-2048
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 ❑ 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: Install security&fire system.
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 CIIn- ❑ No.of Emergency Lighting
grnd. gnd. 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 6
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 ❑ Municipal ❑ Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:" 12
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 0 (Specify:)
I cert(y,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) ❑ owner ❑ owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$45.00
(912 (ggYane
Commonwealth of Massachusetts �i Use C
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'L rain i Permit No.
iw"AI 31 E Department of Fire Services
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Occupancy and Fee Checked
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°' '"�� BOARD OF FIRE PREVENTION REGULATIONS (Rev.9/OS]
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'a 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: 9/27/18
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) 3 St.Andrews Way,South Yarmouth
Owner or Tenant Chouinard Residence Telephone No.
3 I Owner's Address
Is this permit in conjunction with a building permit? Yes X No X k
V Purpose of Building Utility Authorization(ChecNo.Appropriate Box)
��"19 Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters
v rvice Amps / Volts Overhead 0 Undgrd ❑ No.of Meters
0-----Ngmb of Feeders and Ampacity
W W
� Lo�ti nand Nature of Proposed Electrical Work: Install new security and fire alarm
>
N
C
w Completion of the following"
may be waived by the Inspector of Wires.
CLNx�o ecessed Luminaires No.ofCeiL-Susp.(Paddle)Fans Transformers KVA KVA
W CO No°oti uminaire Outlets No.of Hot Tubs Generators KVA
Noof uminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
• grad. grad. Battery Units
•
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 1
No.of Switches No.of Gas Burners No.of Detection and 6
Initiating 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/Alertin Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Diner
Connection
No.of Dryers Heating Appliances KW Security Systems:* 12
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: 2k (When required by municipal policy.)
Work to Start: 9/27/18 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 0 OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application it true and complete
FIRM NAME: Seaside Alarms inc. LIC.NO. 1317C
Licensee: Robert K.Boucher Signature 77LIC.NO.:
(if applicable,enter "exempt"in the license number line.) / Bus.TeL No.' 508-394-0599
Address: 1265 Route 28,South Yarmouth,MA 02664 Alt.Tel.No.:
*Security System Contractor License required for this work;if applicable,enter the license number here: 5-0046
OWNER'S INSURANCE WAIVER: 1 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/AgentPERMIT FEE:$ �
Signature Telephone No. V' -