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HomeMy WebLinkAboutBlde-20-001733 qV .. - '� Commonwealth of Official Use Only c`9 Massachusetts Permit No. 13LDE-20-001733 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:9/30/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm he electncal work described below. Location(Street&Number) 43 WITCHWOOD RD O C--t__C _'YJ (44/14/(el) Owner or Tenant WILLIAMSON THOMAS J Telephone No. Owner's Address 32 GENERAL HOLWAY RD, 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 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 fire place 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 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 ❑ 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 ❑ OTHER 0 (Specify:) 1 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 ( g /©( ((? e r C>mmonwsa.Llfs o///la ac tsl3 ,_ • Official Use Only 1. _81_ . )epartincnt o f.emirs Servicss Petmit No. �:�-� 1 ✓3 =r= ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS {Rev. 1/073:, ... (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 7 CMR 2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIO]'9 C1 (3 Date: c1/�y City or Town of: YAR1VIOUTH To the Inspector of Wires: By this application the widersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) % CCJ I TC A LLeico :7 l Owner or Tenant rvj( c'r'Y- 1 k/Yl7 / /'` Telephone No. 7� r'(�Q� Owner's Address (A) / xJl� o� Is this permit in conjunction with a building permit? Yes El No � (Check Appropriate Box) Purpose of Building (2 _ s (d)�-,.v ►/'-� Utility Authorization No. Existing Service Q Amps ('4-0 LP Volts Overhead 1 Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd>;r ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: p— rd r=//Lt�i. PP(.& 8 l v��.) c2 la L��1�1 t��i3G t2. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell-gasp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmiag pool Above ❑ In- ❑ No.of)znergency Lighting - rrnd. _grnd. Battery IInits U No.of Receptacle Outlets / No.of Oil Burners v FIRE ALARMS trio.of Zones No.of Switches No.of Gas Burners 'No.of Detection and Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/AlertingDevlces No.of Dishwashers Space/Area Heating KW' Local❑ Municipal - Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.ofNo.of Devices or Equivalent Heaters ' No.of Data Wiring: - Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - v OTHER; No.of Devices or Equivalent la Q. Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of lec cal Work: (When required by municipal policy.) JWork to Start: 9 /3 c ( Inspections to be requested in accordance with MEC Rule 1 eland upon completion.INSURANCE COVERAG : Unless waived by the owner,no permit for the performanceyss e unle the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. Theme 43 undersigned certifies that such covers a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Dr BOND ❑ OTHER ❑ (Specify:) ‘ f certify, tinder the pains andenalties o FIRM NAME P fPerlar7',that ltfte information on this application is true and complete. • C. ' T C/e0 / N LIC.NO. Licensee: : d )� 4 'P , ` C rt. , ' Signatu LIC.NO.: (If applicable,ent " empt"in the license number line.) Address: L( S N ci Bus.TeL No.: S-3-— j `Per M.G.L. C. 147,S.57-61,security worrequites D ` f Aft TeL No.: eparnnrnt o Public Safety"S"License: Lic.No. - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner El o coverage normally t. Owner/Agent ❑owner's a ent ill Signature Telephone No. PERMIT FEE: $