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HomeMy WebLinkAboutBLDE-22-001205 R Commonwealth of Official Use Only AfE Massachusetts Permit No. BLDE-22-001205 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:9/1/2021 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) 46 WEBSTER RD Owner or Tenant DAWE ROBERT H SR Telephone No. Owner's Address DAWE ROBERT H JR,46 WEBSTER RD,WEST YARMOUTH, MA 02673 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 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- o 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. TotaloNo.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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: I 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:238 SHERI LN, S WEYMOUTH MA 021901254 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 also/7 /-2., w, LommonuieaCtti of ff�faatac�tiuetlt * !t cc�� Permit No. (C� 4t JJepartment of Jire Services 1 � (Rev.L07J BOARD OF FIRE PREVENTION REGULATIONS j (teacebtant; anda leeChecked ''',r....2,- APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( C), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9 //a/ City or Town of: YA lel ck T/4 _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) YC/ l�cl 4. Owner or Tenant a ,8 DAL/a Telephone No.5°6'. akj Owner's Address '/S. 1=B Sin- 2]4D iti k s7 low .0073 Is this permit in conjunction with a building permit? Yes ❑ No lEr (Check Appropriate Box) Purpose of Building t J -71c_.7" Utility Authorization No. , zr Existing Service/C.S?J Amps/ 76 L Volts Overhead Di"----Undgrd D No.of Meters I New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �/N o 2 r (t-=cme i G W2 . O A.� 0 LD Ge>U2, GK 2 €T /.P- cT c ur 614 1 T P c.tt-a 6-aa ;---=//7-6-0�•Ac€ ,&1-acI E-2 Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires INo.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA KVA Tra 2O No.of Luminaire Outlets 1No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting gmd grnd. Battery Units o 3 No.of Receptacle Outlets / No.of Oil Burners FIRE ALARMS No.of Zones 8 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 ii Heat Pump Number , Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices J No.of Dishwashers ,Space/Area Heating KW Local ❑ 1- Municipal unonnection ❑ Other IS No.of DryersAppliances Heating KW Security Systems:* Y No.of Devices or Equivalent No.of Water No.of No.of Data Wiring.. Heaters KW 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 El trical Work: 9- 0 (When required by municipal policy.) Work to Start: q i3 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 coy•rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ►'t BOND 0 OTHER 0 (Specify:) I certify,under plegkinAl© 0:. .e; ;;,..r.,that the information on this application is true and complete. FIRM NAME: 7 Lists Lane LIC.NO.: I la 'rg A Licensee: �Sottt YaTnottalt.SMA 02664 Signature ....... ..c..4,..,..." L 5�, „ LIC.NO.: (If applicable,eilferMtr ei 10170 ,4' WK r line.) Bus.Tel.No.:781 Sid SS?7 Address: Alt.Tel.No.: *Per M.G.L.c. 147,s 57-61,security work requires 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) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$