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Home My WebLink AboutBlde-20-002520 kkkl V Commonwealth of Official Use Only E` !, Massachusetts Permit No. BLDE-20-002520 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:10/31/2019 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) 107 MERCHANT AVE Owner or Tenant ALLEN LESTER R III Telephone No. Owner's Address ALLEN KATHLEEN T, 107 MERCHANT AVE,YARMOUTH PORT, MA 02675 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 0 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 Telephone No. PERMIT FEE:$50.00 4/i (1(14114 t Ok--C9 " i7) '? K6 ir' ECEIVED ( ,) /i)k 051-,- 2019 ��ss oaff 1 i 4C 3 1 T C,mmonwea[th o/Kddachudaltd Official Use Only I is B :0 (DEPARTMENT cc77 Permit Nor 24)r�7�� N 1 . �s • i . - Dspartmsnt ol.}irs serviced i i;} ____ Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK „I All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 27 CM 12.00 ;J (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /LI .R/i, 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. kJ Location(Street&Number) ) C>.7 0 IC.PI)mivr P/6 Owner or Tenant 'arf,i� F) S Telephone No. "_V Ll T 1r tio1 y ^. Owner's Address /G '7' /Yl` C}f A- fi iiic dal / 4 J Is this permit in conjunction with a buildimpereW Yes ❑ No �� (Check Appropriate Box) Purpose of Building (9_, i.Pat.Cc_. Utility Authorization No. W Existing Service/ Amps cL`/J //7L/Volts Overhead Undgrd❑ No.of Meters New Service'"'-' Ampss . / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /y t N D►2, u LC-- L►►121 C PZ_ Cie TUT -‘,U�.. 67 -s r'//mac- aL,- .�Lo uJ ►'L. 1, Completion of the followintitable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans T q. fTotal Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA - 4 No.of Luminaires Swimmin pool Above In- No.of Emergency Lighting g irnd. ❑ grad. ❑ Battery Units No.of Receptacle Outlets I No.of 011 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 AlertingDevices 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 ❑ 0tb Connection J No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent _ No.of Water KW No.of No.of Data Wiring: Heaters Sips 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 Ele tri 1 Work: " CSil (When required by municipal policy.) Work to Start: !lj /// Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAG : 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 cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE (BOND 0 OTHER 0 (Specify:) I certify,under the pis and penalties of perjury,that the information on this application is true and complete. FIRM NAME: w/a f ACQG OU t jcJ LIC.NO.: //o 'j Licensee: iff-vi a) f- CAL)/6/_) Signatur LIC.NO.: (1f applicab rater"exempt"in the license number li e.) Bus.Tel No.: > /6 ) to75 Address: L/6 Sd i� ,x It ,l - C62�6'yAlt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work quires Department of Public Safety"S"License: Lic.No. 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ 5-0