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HomeMy WebLinkAboutBLDE-19-003934 kik 1\\ Commonwealth of Official Use Only E., ►�\ Massachusetts Permit No. BLDE-19-003934 �c®�•J BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/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:1/3/2019 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 dee Its ork describe below. Location(Street&Number) 23 FORTUNE RD ' tt-_ (&'s Owner or Tenant MCCARTHY MARCELLA Telephone No. Owner's Address CO MARCELLA LYONS,23 FORTUNE ROAD,YARMOUTH PORT, MA 02675 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 ❑ Undgrd ❑ No.of Meters New Service Amps Volts Overhead ❑ Undgrd El No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install 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- 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 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 2a. .=� .noto,coara ofMauachaftS on Use Only r . Permit No — p • 3 4fit aParimarE airs Serviced Occupancy and Fee Checked- 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(14),527 C}'{R 12.00 (PLEASE PRINTININKORTYPE ALL INFORMATIOI9 Date: / /J/ / City or Town of: YARMOUTH To the Inspector of Wires: . By this application the mdetsigned gives notice of his or her intention to perform the electrical work described below. . Location(Street&Number) a 3 FC)/Tit h c Pt'. Owner or Tenant Pe fee- Ly am_5,, Telephone No. Srjf�7Col Owner's Address a- Pt f n5 2a IJ mtcg'-9 f 9 Is this permit in conjunction with a building permit? Yes 0 No ©- (Check A ro Purpose of Buildia p ..• PP Pete Box) g )2e S IL t''c a Utility Authorization No. Existing Service jab Amps (lU/dt/U Volts Overhead ❑ Und �t� grd Ly No.of Meters i 2j....._.New er'vice Amps I Volts Overhead 0 Und d >T ❑ No.of Meters W , Nam of Feeders and Ampacity v' ,Loco on and Nature of Proposed Electrical Work: • > 'o, t.?�it'T elf yh t&Jotl ��c77 fcnc — c�� ark ILS i G .o !CW ! +]� ✓/i�e�e/nCetT l-oL 4 l=liPthilze� Completion of the fo • • - table may be waived by the Inspector of Wires. U'r� Q N6.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total lli: I Transformers KVA _ No. of Luminaire Outlets No.of Hot Tubs Generators KVA Ifo.of Luminaires Swimmin Pool Above In- No.of l.mergency Lighting - g arnd. Brod. ' Battery Units 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 I Tons 1 KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local D Municipal - Connection � �� 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 a ei : • L No.Hydromassage Bathtubs communcations Wiring: No.of Motors Total HP g . OTHER: No.of Devices or Equivalent A. Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Elecijcal Work -3 CO (When required by municipal policy.) 0 Work to Start ) /9// Inspections to be requested in accordance with MEC Rule 10,and upon completion. .4. 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 S undersigned certifies that such cover a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [ BOND 0 OTHER 0 (Specify:) I certify, under the pains and penalties ofperjury,that the information on this application is true and complete. \ FIRM NAME: ,614,41A-C(7010/ LIC.NO.:lld`JrQ Licensee: -,/)9J)/V 79 covin 00 Signature . LIC.NO.: (If applicable,enter"exempt"in the license number line) Address. t EF I.J Co.yAlMCKh r 6�� Bus.TeL No.:mak 7t/ j Per M.G.L. e. 147,s.57-61,security work'requires Department of PublicSafetyAlt Tel.No.:_�_ eP "S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n — required by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner 0 owner's agent i. t Owner/Agent Signature Telephone No. PERMIT FEE:$ `5 b