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Home My WebLink AboutBlde-20-000172 �1\� Official Use Only - \ Commonwealth of E` / Massachusetts Permit No. BLDE-20-000172 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:7/11/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 26 FORTUNE RD Owner or Tenant TAYLOR SANDRA J TR Telephone No. Owner's Address TAYLOR FAMILY REV LVG TRUST,2120 NIGHT PARROT AVE, NORTH LAS VEGAS, NV 89084 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 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 grnd. grnd. Battery Units No.of Receptacle Outlets 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatine 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/Alertinc 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 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:7 Liefs Lane, S Yarmouth MA 02664 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 9 , yyy�jj �- Commonwealth ommor wea of///addach deft Official Use Only .., A 0_1 , 2epa t o f. e s Permit No. —v c 1 z_, BOARD OF FIRE PREVENTION REGULATIONS f. Occupancy and Fee Checked [Rev. 1/07] cleave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 'ME ,527 12 D0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / // 7 City or Town of: YARMOUTH To the Inspector of Wires: By this application the widersigned ves notice of his or her intention to perform the electrical work described below. ® Liocai;on (Street&Number) Q 0f�fl j ci 12 d • U.! en" 41�n r or Tenant S�//�jn f� /� G12 >rj-S O`lvnl•is Address ,. /_ �[7 A ' Telephone No. 7 /� -- ! wan permit in conjunction with 1 building permit? Yes ✓ ❑ Na C (Check Appropriate Box) LL9 P� u L se of Building a S / Utility Authorization No. l 110.54 i . Service oZQ.ca.i Amps ll. (hi oZyl/Volts Overhead ❑ Uadgrd❑ No.of Meters — Amps / Volts Overhead E Uad grd ❑ No.of Meters Num.:+ of Feeders and Ampacity Location and Nature of Proposed Electrical Work: i �i/arrnc✓��c' Awl!)Awl!) `►2 I Mcr1, �Zr—c.74Ic�. �t�l.�'a— /i ?/ccvt. ►ti Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ce�1.-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 L�mergency Lighting _rnd. (mid. � Battery Units No.of Receptacle Outlets 3 No.of Oil Burners FIRE ALARMS [No.of Zones • No.of Switches No.of Gas Burners No.of Detection and InitiatinE No.of Ranges Na of Air Conti. Tons Total Devices No.of Alerting Devices v No.of Waste Disposers Heat Pump Number No.of Self-Contained ki Totals:I I Tons KW Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Q Municipal ion Connect ❑ Other Ni No.of Dryers Heating Appliances , 'Security Systems:* No.of Water No.of No.of Devices or Equivalent HeatersSZ ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromass age Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of lec cal Work C� (When required by municipal policy.) Work to Start: // /i 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 Q the licensee provides proof of liability insurance including"completed operation"coverage or its substantial a uivalen v undersigned certifies that such covers a is in force,and has exhibited proof of same to the permit issuing office. t' The SZ CHECK ONE: INSURANCE IV BOND ❑ OTHER 0 (Specify:) z I certify, under the pa' and penalties o I ) fpe!u perjury,that the information on this application is true and complete. FIRM NAME: .Q t..% C.ie.. l i vt 41 Licensee: e� 4. LIC.NO.: a 7 f " _ Signature Si (If applicable,enter exempt'in the license number line.) LIC.NO.: Address: Bus.Tel.No.: �`7�/ d 6S''sx j Per M.G.L. c. 147,s.57-61,security,work requires Department of Public SafetyAlt.TeL No.: 7 — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability Lin.No. S� insurance coverage n required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner o Owner/AgentLd ❑owner's a enL Signature Telephone No. PERMIT FEE: $ SD