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Home My WebLink AboutE-19-2713 0 Commonwealth of official Use Only Massachusetts Permit No. BUM-19-002713 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/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 INFORMATION) Date:11/5/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice or his or her intention to pertornr the electrical work described below. Location(Street&Number) 21 NAUTICAL LN . Owner or Tenant ANGLIN FRANCIS X Telephone No. Owner's Address ANGLIN EUGENIA F,21 NAUTICAL LN,SOUTH YARMOUTH,MA 02664 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 ❑ No.of Meters New Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Receptacle for fireplace blower. 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- ❑ No.of Emergency Lighting >;rnd. grnd. BatteryUnits 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 ❑ 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 ❑ 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 //ss ry� lammoruuea h el tt/assachwrin cial Use Only --a---irks 7 i{'�' apart./ -!c7 [7 7_Z / `��= 1Je ar'tmeat I .gine�7 Permit Nt 3 p Services BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev. lro7] . (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code/ L),$27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,�J /fix 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) / Pa4,71C4( tc n to cro •/ ibmar'77 OwnerorTenant r- '5 Ahi Zip; Telephone No.7$1S:7____,"Ster Owner's Address a l fru s T1 r at- [/hue- 7/Z.t mcu'H9 of C 4 c' -- Is this permit in conjunction with a building permit? Yes 0��77 No..,Er Purpose of Building (Cheek Appropriate Boz) f2e s 1 J"h ce, Utility Authorization No. Existing Service / CU Amps J>c. j cr Volts Overhead 2 Undgrd El No.of Meters New Service Amps / Volts Overhead 0 Und ETd 0 No.of Meters Number of Feeders and Ampacity • Location and Niture of Proposed Electrical Work: jyt man_Ei.ern? 1c4nL PlOAT. Ct4 T(er awl; F1/46" Completion of thefollowing_table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cal-Sago.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- Nrnd 0 Battery Units Na.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'Number I Tons IKW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal Low 0 Connection 0 Other No.of Dryers Heating Appliances K V Security Systems:` No.of Water No.of Devices or Equivalent Heaters KW No.of 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 derail if desired or as required by the Inspector of Wires. Estimated Value of E ectrical Work: 3-3-0- (When required by municipal policy.) Work to Start' // C 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 [y 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: qe.ev r n I• C yZN LIC.NO.: 1(d )l-i3- Licensee: iiki,me, ,it A' opt., her Signature woj/ , y. LIC.NO.: (If applicable,enter "exempt' in the license number ne) Address. 7 L / &FS LN A/1rntu'rl 419- .C.6-6,‘"9 BuAlt tTel.No.• _7w I'�g j *Per M.G.L.C. 147,s.57-61,security work requires epartment of Public Safety"S"License: Lic.No.No.:____________ / Q 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 a n Owner/Agent agent g j Signature Telephone No. I PERMIT FEE: $ 1