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Home My WebLink AboutBLDE-22-004250 or t''') t ,\C7 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-004250 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:1/31/2022 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) 9 Vernon St Owner or Tenant MICHELLE GRAVELINE/GRAVELINE TRUST Telephone No. Owner's Address 9 VERNON ST,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: Security&fire alarm system. 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 1 No.of Switches No.of Gas Burners No.of Detection and 9 Initiative Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices 10 Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices 7 No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: 6 Connection No.of Dryers Heating Appliances KW Security Systems:* 16 , No.of Water ' No.of Devices or Eauivalent Heaters K No.of No.of Ballasts Data Wiring: Siens No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: 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 ❑ BOND 0 OTHER 0 (Specify:) 1 certify,under the pains and penalties ofP perjury,u that the information on this applications true and complete. FIRM NAME: Robert K Boucher Licensee: Robert K Boucher Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 1317 Address:218 SETUCKET RD, YARMOUTH PORT MA 026752258 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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/Agent ) 0 owner 0 owner's agent. Signature Telephone No. 4--u- PERMIT FEE:$45.00 Commonwealth of Massachusetts {official Use Only "`i kt; ermit No. g—V2-- -0 f. Department of Fire Services ,. t I r Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (leave blank) 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 TYPALL INFORMATION Date: C/ 2 51- City or Town of: f G(rra, 0 L..FA 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) Vim, -inc S lei- Owner or Tenant t ) r-e�0.,j- (k;/a 416\- G -c.0 k SL t Telephone No.C$22SS Sv �?// Owner's Address .P c' R cx '/p A-e_w 4 j1 O.-.)-G ( Is this permit in conjunction with a built[ing permit? i) No (Check Appropriate Box) Purpose of Building 12es,,-z 'l) 1 Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: vd( .�1 5 _-_c_.-. Completion of the following table may be waiv d� 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 grad. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones / No.of Switches No.of Gas Burners 'No.of Detection and q Initiating Devices No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices `0 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 Otci�� Connection No.of Dryers Heating Appliances KW Secs:* urity Devices or Equivalent/6 No.of Water No.of No.of KWData Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP 'Telecommunications Wiring: ff L� No.of Devices or E uivalent OTHER: F[O� c: S�n 3 e!'3� ( ) ' it Ll- AS''s €,,,i, u (---;> > Attach additional detail if desired, or as required by e nspector of Wires. Estimated Value of Electrical Work: NC(.a0 C. (When required by municipal policy.) Work to Start:C/-.)._ t- 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 ❑ (Specify:) I certl#,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Seaside Alarms inc. LIC.NO.: 1317C Licensee: Robert K. Boucher Signature Fag is..",, P2f.,'40,7—LIC.NO.: (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: . Address: €265 Route 28,South Yarmouth, MA 02664 ;0R-.394"0549 Alt.Tel.*Security System Contractor License required for this work;if applicable,enter the license number here:No.: 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ i'5 v`'