HomeMy WebLinkAboutBLDE-23-001429 or Commonwealth of Official Use Only
4.1,11% Massachusetts Permit No. BLDE-23-001429
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:9/19/2022
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) 12 SYRITHAS WAY
Owner or Tenant HACKETT JAMES P III Telephone No.
Owner's Address HACKETT MARY SUE, 301 MUSTERFIELD RD,CONCORD, MA 01742
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: Upgrade security&fire systems.
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 2
No.of Switches No.of Gas Burners No.of Detection and 13
Initiative Devices
No.of Ranges No.of Air Cond. Total
No.of Alerting Devices 13
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Eauivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Siens No.of Devices or Eauivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: 1
No.of Devices or Eauivalent
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: 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 my
signature below,I hereby waive this requirement.I am the(check one) ❑ owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$45.00
c 119(L?/2;
Ems, Commonwealth of Official Use Only
40Massachusetts Permit No. BLDE-23-001429
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:9/19/2022
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) 12 SYRITHAS WAY
O TeaCT P TelephQ�p�l
Owner'swner or Addressnnt RACKETY HA KET MARYJAMES SUEIll
, 301 MUSTERFIELD RD, CONCORD, MA 01742T"ele l
Is this permit in conjunction with a building permit? Yes 0 No 1< '(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 v/
Location and Nature of Proposed Electrical Work: Upgrade security&fire systems. V7 ^v r//'1
Completion of the f4&llowr /Jle may waived by the Inspector of W'u
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans `ft s *mar KVA
Q
No.of Luminaire Outlets No.of Hot Tubs etors.'> KVA
Pool Above ❑ In ❑ ' Nye of Emergency L: hting
No.of Luminaires Swimming grnd. grnd. 1 L Battery Units
No.of Receptacle Outlets No.of Oil Burners FIREALARMS No.of Zones 2
No.of Switches No.of Gas Burners No.of Detection and 13 \
Initiating Devices i
No.of Ranges No.of Air Cond. Totalo No.of Alerting Devices,,>' 13 ..
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 0 Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Eauivalent ----
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: 1
No.of Devices or Equivalent M
OTHER:
Attach additional detail if desired,or as required by the Inspector of W
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 ofperjury,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 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:$45.00
fax
E. cc•mmonwealth of Massachusetts Official Use Only
E. - /I Permit No. eZ3' ( `--1'
t� ;f 7 'epartment of Fire Services
_, 122 Occupancy and Fee Checked
=7 B A'D OF FIRE PREVENTION REGULATIONS [Rev.9/05] (leave blank)
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BVILDIN F' T 'ION FOR PERMIT TO PERFORM ELECTRICAL WORK
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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: 9/14/22
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) 12 Syritha's Way,SY
Owner or Tenant James Hackett Telephone No.
Owner's Address Same
Is this permit in conjunction with a building permit? Yes No X (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Upgrade security and fire alarm after construction.
Completion of the following table may be waived by the Inspector of Wires.
otal
No.of Recessed Luminaires No.of Ceil:Sus (Paddle)Fans No.roof TVA
P Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of-Emergency Luting
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners o. nDeten and
Initiating
Devices 13
Tot
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 13
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
P Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other
P Connection
No.of DryersHeating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters KW Signs Ballasts No.of Devices or Equivalent
No.H dromassa a Bathtubs No.of Motors Total HP TelecommunicationsNofDeieor Wiring: 1� ,
Y g No.of Devices Equivalent
OTHER:
Attach additional detail if desired or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 5k (When required by municipal policy.)
Work to Start: 9/15/22 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 El (Specify:)
1 certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Seaside Alarms inc. ,/e7y
NO.: 1317C
Licensee: Robert K. Boucher Signatures/ 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)❑owner ❑ owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $ rl. —