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Home My WebLink AboutBlde-20-001383 or Commonwealth of Official Use Only �� Massachusetts Permit No. BLDE-20-001383 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [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:9/11/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm thg,tlgctrical work desc 'bed below. Location(Street&Number) 157 NORTH MAIN ST g,U'(. G C.l.t . i--i.t Owner or Tenant eliallalsb2tIZIZIMilit=141iFIr Telephone No. Owner's Address ,,`"'e— T�ly7l URi, izrs— 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 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 0 In- ❑ No.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 0 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 ` (9, 9/ ,7 c kC _ _. lth.o//I/a�ac tt6 Official Use Only Commonwealth. "i�' "'" t c� c� Permit No. %�,-k 7 :_ — 2)epartment o`..tire�ervice! !1— a t i-� Y'"1�\ll~r ' Occupancy and Fee Checked a 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 PRINT IN INK OR TYPE ALL INFORMATION) Date: ' /i t l/7 City or Town of: /4-�,,yl c4 To the Inspector of Wires: By this application the undersign gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) /S 7 W 011� Al19-IAj S7' Owner or Tenant DAP B f-o am L /)1 c, La cej A Li.; Telephone No. /)' 733 �04. Owner's Address / J.V 3 eat L 1/11-4,1 k)./ r2.-psc4D C 1 (3 c, /C,7 Is this permit in conjunction with a building permit? Yes [" No [ (Check Appropriate Box) Purpose of Building /ee S/ c1 02,c.a Utility Authorization No. Existing Service L LA) Amps (A, /a4 Cr Volts Overhead Er 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: in/ Nut E.-le-cm 1 L p t —. O ItE a-to cixivc C ft l-T fiun. F isc:nLacc Completion of the following_table may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No. f Trano KVAsformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Pool Above In- No.of Emergency Lighting No.of Luminaires Swimming grnd. grnd. ❑ Battery Units No.of Receptacle Outlets 7 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. Toil No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Conn Municipecti o al n ❑Other No.of Dryers Heating Appliances rcurity Systems:* No.of Devices or Equivalent No.of Water , 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 E ec ' al Work: CC.} (When required by municipal policy.) Work to Start: // Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 BOND El OTHER El (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: X/e-V/A) c_4(4.1/AI LIC.NO.: //at 7 j 4 Licensee: -C-V/0") 4.- c-e( u/v Signaturte 1� J_./_,...., LIC.NO.: (If applicable,enter "exempt"in the license number line.) i Bus.TeL No.: 7d7 fId STW Address: Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. 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)❑owner ❑owner's agent. Owner/Agent I PERMIT FEE: $ Signature Telephone No.