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Home My WebLink AboutE-20-3191 Commonwealth of Official Use Only Permit No. BLDE-20-003191 Massachusetts 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:12/4/2019 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) 2 ST ANDREWS WAY Owner or Tenant LAPERLE RAYMOND N Telephone No. Owner's Address LAPERLE DENISE M,2 ST ANDREWS WAY,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 gas 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 ❑ 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 ❑ 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 0 owner's agent. Owner/Agent Signature T lephone No. PERMIT FEE: $50.00 7')( V /p `//� y�y/j _ l,ommonaiscrith el///assaults Official Use Only ■ = ,, • • .=imi : 2eparimant o f &Miw Pelt No. �2�` =�j q • — f BOARD OF FIRE PREVENTION REGULATIONS , •O p�and Fee Checked cave blank APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 12.00 • (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: 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) Owner'or Tenant P i y L P&-n1 T Owner's Address / Telephone No. y y�� Gg "k LI4V SO ✓ tat Gv 77Y Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building (Check Appropriate Box) Utility Authorization No. Existing Service la) Amps fa)/1 Volts Overhead E L`l" Unci'rd❑ No.of Meters f New Service Amps / Volts Overhead Number of Feeders and Ampacity ❑ Undgrd 0 No.of Meters Location and Nature of Proposed Electrical Work - � �/ [van .�i✓6.-TR le�L. 0 vz auZ-Lr� y 6 t= L-GOe?'L� Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-S�• ) Tr addle Fans Tr s Total ansformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Po• ol Above 0 Ia- tvo,of 1~:mergency Lighting _ grad. gruel. 0 Butte Units No.of Receptacle Outlets No.of OR Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.of etection and •-• Initiating Devices No.of Air Coed, T0� No.of Alerting Devices No.of Ranges Tons eat Pump umber Tons o.of elf-Contai No.of Waste Disposers Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Ll❑ Municipal No.of Dryers Connection 1-1 Outer ry Heating Appliances ,i, Security Systems:" No.of ater No.of Devices or E uivalent Heaters ' °'° ° °f Data Wiring: Si s Ballasts No.of Dvices or E uivalent d No.Hydromassage Bathtubs No.of Motors Total HP eco o f Devices Wii tug: O I"HER• No.of Devices or uivalent V II Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Worly Work to Start: � CQJ (When required by municipal.policy.) /RAGE: Unlelnspectionsved to be requested in accordance with MEC Rule 10,and upon completion. I" INSURANCE COPEwa v the licensee provides proof of liability insurance includingby the �"completedtoperati coverage or its substantial for the performance of electrical ak mayissue unless undersigned certifies that such cove ge is in force,and has exhibited proof of same to the permit issuing fecgemvalent The t , CHECK ONE: INSURANCE [BOND 0 OTHER. ❑ (Specify:) I certify, under the p and penalties ofperjury, pe �"•) p that the information on this application is true and complete. Ni FIRM NAME: s C►7 Arxi Licensee: LIC.NO.: /,� 1"}3- (Ifapplicable,enter••eYSignature LIC.NO.: (If in the license number line.) Address: LI t7='S ( J S� Bus.TeL No.: a . `Per M.G.L. c. 147,s.57-61,security work requir Department Alt.TeL No.: OWNER'S INSURANCEepartment o blic Safety"S"License: Lic.No. — required bylaw. WAIVER: I am aware that the Licensee does not have the liability insurance coverage n�— i Owner/Agent la By my s`a�e below,I hereby waive this requirement. I am the(check one 0 ownerg rtaally i Signature 0owner's aeent