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HomeMy WebLinkAboutblde-19-005816 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-005816 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:4/17/2019 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) 130 SOUTH SHORE DR Owner or Tenant KOEHLER STEPHEN W Telephone No. Owner's Address 703 ASH ST, BROCKTON, MA 02401-5755 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: Install security&fire system. 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 No.of Oil Burners FIRE ALARMS No.of Zones 1 No.of Switches No.of Gas Burners No.of Detection and 6 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices 2 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* 10 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Robert K Boucher Licensee: Robert K Boucher Signature LIC.NO.: 1317 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:218 SETUCKET RD,YARMOUTH PORT MA 026752258 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: $45.00 L- Commonwealth of Massachusetts cUse Only C� } j"' f' Department of Fire Services Permit No. G r Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 4/15/19 City or Town of: Yarmouth To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 130 South Shore,S. Yarmouth Owner or Tenant Koehler Residence Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes X No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters --- .... ..,Member of Feeders and Ampacity i•• ' -Lion and Nature of Proposed Electrical Work: New security and fire alarm system to current code. ti'nlm r n% ( Completion of the following table may be waived by the Inspector of Wires. .: Nod.of atecessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA 1,t KVA L.$ , Nei ot,�Luminaire Outlets No.of Hot Tubs Generators ' '' . . Net at Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units o.al Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 1 No.of Detection and No.of Switches No.of Gas Burners Initiating Devices 6 No.of Ranges No.of Air Cond. Total No.of Alerting Devices 2 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 ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* 10 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 desirect or as required by the Inspector of Wires. Estimated Value of Electrical Work: 3k (When required by municipal policy.) Work to Start: 4/14/19 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 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 X BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Seaside Alarms inc. • LIC.NO.: 1317C Licensee: Robert K. Boucher Signature / 43______ LIC.NO.: (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: 508-394-0599 Address: 1265 Route 28,South Yarmouth, MA 02664 Alt.Tel.No.: *Security System Contractor License required for this work;if applicable,enter the license number here: S-0046 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)El owner ❑owner's agent. Owner/Agent PERMIT FEE: $ 1'1 S 1 Signature Telephone No.