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HomeMy WebLinkAboutBLDE-22-001784 ` L( Commonwealth of Official Use Only EE ` Massachusetts Permit No. BLDE-22-001784 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:9/28/2021 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) 359 ROUTE 6A Owner or Tenant Claire Boardeau Telephone No. Owner's Address 359 ROUTE 6A,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 ❑ 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. To No.of Alerting Devices 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 Ballasts Data Wiring: Heaters Signs 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 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: $50.00 4y� teal Use Only , commonwea o /rfiWa lle �� " ,•[ ,, Apartment jam\ } j (j l No. re ` BOARD OF FIRE PREVENTION'`REGULATIONS ` ' ; ccy and Fee Checked , ;.,�+ [Rev.1/0171 ( nk) i ' I PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK a.. All wolf to be pelkrme4 mco ao a wide the Electrical Code(MEC),5 CART 12.00 LU (P.L: • E PRINT IN INK OR TYPE ALL INFORMATION) Date: Vol d,/ ce6 .,,.___ m City or Town of: )//Q-4 AI G 4 TI) _To the Inspector of Wires: .� $1 . application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 3 fj /2-1 C XI Owner or Tenant lG //C 4 94 r$:Jeoq Telephone No y Owner's Address 3 s a 6 Is this permit in conjunction with a building permit? Yes ❑ No Br- (Check Appropriate) r(2��.� �/ /f) Purpose of Building YU`-`'/� Utility Authorization Na Existing Service 1_____4;.? Amps /(:)e.,k)/t Volts Overhead Cr Undgrd❑ No.of Meters New Service Amps ______/ outs Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity il- Location and Nature of Proposed Electrical Work: A f IJ gyp- E/ f:-. 2(c-i-? L Ou Completion ofdeefo,tlowing table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No-°f Total Transformers KVA g No.of Luminaire Outlets No.of Hot Tubs Generators KVA pe No.of Luminaires Swimming Pool Above 0 mo- ❑ No.of Urate Lighting O r t� # �- Battery No.of Receptacle Outlets / No.of Oil Burners FIRE ALARMS INo.of Tones r No.of Detection 111111 No.of Switches No.of Gas Burners Initiating Devises No.of Ranges No.of Air Coed. Total Noof Alerting Devices No.of Waste DisposersH .-Number-, Tons KW No. Self-Contained Totals: . I Detection/Aka-tin Devices ts g No.of Dishwashers Space/Area Heating KW Local ❑ Connection n © Other cs No.of Dryers Heating Appliances KW Security Systems:* yl,of Devices or Equivalent No.of Water No.of No.of Data W 1 . Heaters KW Signs Ballasts No.of i '«- or rivaient No.HydromassageBates INo.of Motors Total HP T _ i No.of Devices orEquivalent OTHER: Attach additional detail ifdesirad,or as required by the Inspector of Wires. Estimated Value ofd�.«. «- Work: (When required by municipal policy.) Work to Start: q rL'i- Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO f GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability Insurance inclining"completed operation"coverage or its substantial equivalent.The Undersigned certifies that such coy .: