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Home My WebLink AboutBLDE-21-004644 ay° or f i' `- Commonwealth of Official Use Only ,',l�' Permit No. BLDE-21-004644 1-. Massachusetts 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:2/16/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 394 LONG POND DR Owner or Tenant ETHIER GERARD R Telephone No. Owner's Address ETHIER MARTHA P, 18 SHATTUCK STREET,GREENFIELD, MA 01301 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. 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 ❑ Municipal Connection 0 Other: 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: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 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: $50.00 :'co (2,I344 * 4C ornrnanwea[tla o� asfac�iu9efls f� Official Qn c c%�� // Permit No. �---' 6 • f .2eparlmenl of Dire .ervicet 1f A Occupancy�"�FeeChecked BOARD OF FIRE PREVENTION REGULATIONS ., ,,as' [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: )- 1' - C/ City or Town of: ,,4rim CAt 7-1-1 _To the Inspector of Wires: By this application the undersigned gives noticeof his or her intentionio to perform the electrical work described below. es Location(Street&Number) -- / 9 � on 6- !' "0 P/zf Vc Owner or Tenant (sW.--rq,d E74 l e/ Telephone No. yf 3 Ca a.30)&3 Owner's Address /$ c Aes rnl Ck ST CG, e;A FieV ild,1- Is this permit in conjunction with a building permit? Yes ❑ No [}' (Check Appropriate Box) Purpose of Building /'S/ vLu. o Utility Authorization No. Existing Service / Amps/2a- /?- Volts Overhead Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity ,,,yy,, Location and Nature of Proposed Electrical Work: /)l /u -- GL 1% c--C it/c14' - Q i� OP ( JC1/2 Gli i LeT P j2. 6793 F//Z PL1)-66,6 LW.)tYL 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 I Transformers KVA 2 No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. gmd. Battery Units 0 Jo No.of Receptacle Outlets / No.of Oil Burners FIRE ALARMS INo.of Zones 1- 3 No.of Switches No.of Gas Burners No.of Detection and I Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons v Heat Pump Number Tons KW No.of Self-Contained re No.of Waste Disposers Totals: Detection/Alerting Devices m No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection 2 No.of Dryers Heating 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.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: 1 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: /z//o'/ 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 )'i BOND.0 OTHER ❑ (Specify:) I certify,under pievkinket4sey '� r, -', .,that the information on this application is true and complete. FIRM NAME: 7 Lists Lane LIC.NO.: 1 1(3 7E A Licensee: (South Yarmouth.MA 02664 Signature _...c-�-�.�.4y� -- LIC.NO.: (If applicable,eiffer37M, 1 g t . r line.) Bus.Tel.No.:7 /Sid —S-CV 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 i T„ TN T T.1"-TT T A