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Home My WebLink AboutBlde-20-001646 or �p�� Commonwealth of Official Use Only L. ,t / Massachusetts Permit No. BLDE-20-001646 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:9/25/2019 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) 21 MIRIAH DR Owner or Tenant HIRSHBERG JEFFREY R Telephone No. Owner's Address 159B TALL OAKS DR, S WEYMOUTH, MA 02190 Is this permit in conjunction with a building permit? Yes ❑ 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- 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/Alertine 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 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: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 1, .,&.,-vj C.f - -- lrom moluvecih of Massachusetts • Offi cial Use Only `ink , 2eparfinent of 5ire Serviced Permit No. BOARD OF FIRE PREVENTION REGULATI Occupancy and Fee Checked ' ONS jRev. 1/07) (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), .00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7 e>,c• f /17 City or Town of: YARMOUTH To the Inspector of By this application the midersigned gives notice of his or her intention to perform the electrical rk described below. Location (Street&Number) 'al iiek 1 a r v'I-1- /)' i Owner.or Tenant t �l� �1,�s QXV n` Telephone No. Owner's Address ..5� ,,. -��U ��)-. / S'5 T TA-/1 6Y3/JS O?ILA S (:).. J/ l�`y TV k1J - a aio Is this permit in conjunction with a building permit? Yes Purpose of n ❑ No ✓ (Check Appropriate Box) Building c2 v-. / Cis 1,.ti Utility Authorization No. Existing Service Amps / Volts Overhead D. Undgrd ❑ No.of Meters i- ".. ti.___ New Service Amps / Volts Overhead❑ Undgrd ❑ Na.of Meters 4 ?Number of Feeders and Ampacity r` > !, UStl'r /I Location and Nature of Proposed Electrical Work: AAi N E c-� IL fii-eL `�' I rz)/21s Ci Completion of the followinvable may be waived by the Inspector of Wires. No.of Recessed Luminaires No,of No.of Cee'i.-Susp.(Paddle)Fans Total Transformers KVA Lt_i ! No.of Luminaire Outlets No.of Hot Tubs �' G� 'i' Generators KVA INo.of Luminaires Swimming Pool Above ❑ ill.. ❑ No.of 1✓mergency Lzghung - gmd- mod. Battery Units "`,,- `[ Na.of Receptacle Outlets _..; tl ( No.of Oil Burners FrRE A.LARIVIS JNo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump l Number I Tons 1 KW 'No.of Self-Contained Totals:I Detection/Alerting Devices J No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Omer No.of Dryers Heating Appliances 'Security Systems:* • No.of Water No. of No.of Devices or Equivalent Heaters KW Signs BallastsV Data Wiring: - No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: .N Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Elec ical Work: (When required by municipal policy.) Work to Start — Pa P cY) 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 J the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The i undersigned certifies that such cove a is in force,and has exhibited proof of same to the permit issuing office. 1J CHECK ONE: INSURANCE BOND I certify, under the pal and penalties o ❑ OTHER ❑ (Specify:) fperju►y,that the information on this application is true and complete...) FIRM NAME: �� Licensee: LIC.NO.: '' t 7T C'V/��,. Qcpi i) Signature " + (If applicable,enter t the license number line.) z _e•NO.: Address: S L iv ,S o, � �1 / - Alt_TeL No.: Bus.TeL No.: a J `Per M.G.L. c. 147,s.57-61,security work requires epartment of Public Safety Q OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability Lin.No. 5 Ownerequirrd by law./Agent Agent By my signature below,I hereby waive this requirement. I am the(check on 0 owner coverage n— o Signahire ❑owner's a ent i�i Telephone No. . PERMIT FEE: S .44