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Home My WebLink AboutBLDE-19-002644 Commonwealth of OffrcialUse Only a. . Massachusetts Permit No. BLDE-19-002644 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked f Rev.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:11/1/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perlonu the electrical work described below. Location(Street&Number) 902 ROUTE 28 Owner or Tenant GERARDI DIEGO A Telephone No. Owner's Address GERARDI SASHA A, 17 BRIDLE PATH, BREWSTER, MA 02631 Is this permit in conjunction with a building permit? Yes ❑ 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: Receptacle for blower in fireplace. 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- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 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 Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 f 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: Kevin A Cronin Licensee: Kevin A Cronin Signature LIC.NO.: 11275 (If applicable,enter"exempt'in the license number line.) Bus.Tel.No.: Address:238 SHERI LN,S WEYMOUTH MA 021901254 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 Telephone No. PERMIT FEE:$80.00 1OV 01 21:18 _• U l eth si • 7.- : „ . amore. f m7� r„,,a ' et J. � �tO-ffi(cial Use Only-Tr_`��= 1JeParlmenl of..Yirr-_CervicesPermit No. l=t�— • I' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS •ev. 1/07) ' cave blank APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ,5 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: J/ l/ //f City or Town of: YARMOUTH To the Inspector of Wires: . By this application the pndersigned gives notice of his or her intention to perform the electrical work described below. • . Location(Street&Number) 9 Q 7 0 it TW Ylin bier 4 Owuer'orTenant eb 1 k Co 6--el2 4n Dr Telephone No.SEcalpao, Owner's Address . 90 h (fl r41 S aSinn grnQ M ro Is this permit in conjunction with a building permit? Yes 0 No Er (Check Appropriate Boz) Purpose of Building 720‘)T4 s ys riff Utility Authorization No. Existing Service c rQ/Amps NCL.,103eVolts Overhead 0 Und d gr ❑ 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: loot AGE c.-TE/eat 67?a_SLE Completion of thefollowintable may be waived by the Inspector of:Fuer. No.of Recessed Luminaires Na of Ce0 Susp.(Paddle)Fans • No.of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot Tabs Generators KVA •• No.of Luminaires Pool Swimming Above In- Naattery UTirmnitsergency Lighting❑ crud. 0 B No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Ton No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number ITons IKW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Load❑ Municipal Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:• No.of Water No,of No.of Devices or Equivalent Heaters No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: Na of Devices or Equivalent OTHER: - Attach additional detail fderirect or as required by the Inspector of Wire. Estimated Value of E ec 'cal Wort` 3 60 (When required by municipal policy.) Work to Start: ( Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO ERAGE: 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 (Q( BOND 0 OTHER 0 (Specify:) I cern)",under the pains and p nalties ofperjuty,that the information on this application is true and complete. FIRM NAME: Air(J/r A •(pcn/vt LIC.NO.: d TIS Licensee: X----500); 1l, Oven, /., . Signature ditiai�c„-c....r� LIC.NO.: (If applicable,enter "ecempt"in the license number line) Bus.Tel.No: 7 )•zT�n Address. L, N S Lnl fin. L/,�1rIYI1GvI`i ��1 nn�� fJ 'T____ w t'9 J 'Per M.G.L.c. 1 7,s.57-61,security work requifes Department oIPub�Safety� Littense: Alt Lic No. < OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally t required by taw. By my signature below,I hereby waive this requirement. I am the(check one)El owner ❑owner's agent m Owner/Agent -' Signature Telephone No. I PERMIT FEE: $