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Home My WebLink AboutE-19-3591 d ��ii,,,,�� Commonwealth of Official Use Only KE .flrl; • Massachusetts Permit No. BLDE-19-003591 e ......::... BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 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:12/13/2018 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) 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 ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd Cl 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: new 120V,20 Amp circuit to dishwasher(781-812-5579) 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 Abave ❑ In- o No.of Emergency Lighting grnd, grnd. 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. Tool No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: 'N Defection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* '4o,of Devices or Enuivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens 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 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:$50.00 Official Use Only Commonwealth.al///W allachnitit! fa * t "_- 3 cy� cc77 �s Permit No. &IDE — /9 • 03977 ' 1Je/rarfmtnt a/Jire�7irviu! Occupancy and Fee Checked kit) 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 PRIAT IN INK OR TYPE ALL INFORMATION) Date: --7a-//a Ii r City or Town of: VA-gm Ua T/1 To the Inspector of Wires: • Dy this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) a J A/414 1/rpt.--',1-. (1-Nt - Owner orTenant fil?RNCr s Ii/1/4/ pe.r if Telephone No.7t/ `771 S-01-1— Owner's fig-cOwner's Address all.IAu?,OIL LN. S o.yAnsi u1l1he )i OItC y Is this permit in conjunctionnwith arbuilding permit? :• Yes 0 No [-`. (Check Appropriate Boa) Purpose of Building /`@ s lid cr,c. Utility Authorization No. nEc sstmg ice /CC.' Amps /20..i o7y t/ Volts Overhead❑' Undgrd❑ No.(*Mitten zrs ILi j x J a]Yew-S't Ice Amps 1 Volts Overhead 0 Undgrd 0 No.of Meters 1>Asts t niumhetJ ,f Feeders and Ampacity ratio, and Nature of Proposed Electrical Work ret(n cot, t_El re-Tri ( cn L ME JJ r J, G V/a.o. 4yln I Ill .i ,o ' !;., • frac s4 r T G D/ SHcs/•- G•t7°' �`W ,z Completion of the jnllowln&fable may be tvatved by the Ins eror of Wires. 111 . Na;of tensed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Total .v' L ) Transformers KVA j `" No.of 11am{naire Outlets No.of Hot Tubs Generators KVA No.of Lmnivaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting fund, grnd. Battery Units . No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones o No.of Switches No.of Gas Burners No. In Detection and 44 nitiating Devices No.of Ranges No.of Air Cond. Tons 1No.ofAlerting Devices No.of Waste Disposers Heat Pump Number W Tons KNo.of Self-Contained p Totals: " -- Detection/Atertin Devices Z No.of Dishwashers Space/Area Heating KW Local 0 AI°nnectioittpann 0 Other Con VSecurity Systems:* No.of Dryers Heating Appliances KW Na of Devices or Equivalent •`t No.of Water No.of No.of KW Ballasts Data Wiring. CZ Heaters Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunicationso.of Devicer Equivalent OTHER: d Attach additional detail if desired or as required by the Inspector of Wires. t'll Estimated Value of Electrical Work: 3 3 (When required by municipal policy.) p Work to Start: /a-I/d.!/P 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 J undersigned certifies that such coverage is in force,and has exhibited proof of same to the pennit issuing off ice. CHECK ONE: INSURANCE EPKBOND 0 OTHER 0 (Specify:) I certify,ander the pains amipenalties of perjury,that the information on this application is true and complete cj FIRM NAME: k'Cu ii R • Ott* In /ALIC.NO.: I t? '754. Z ____/<%C,c Licensee: ,r h n _i�• C t'- le_ Signaturec., __4< / LIC.NO.: (Ifapplicable,enter "exempt'in the license ntmtber line.) Bas TeL I�'o:`J$( h 11 rSr7S 0" Address: '7 L I L-72.\ / d1 .3 C • v#/ a - i It hit C '&ti AIGTeLNo.: *Per M.G.L.c. 147,s.57-61,security work requires'Departinent of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hate the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/AgentI PERMIT FEE: $ SignatureTelephone No.