HomeMy WebLinkAboutBLDE-21-006285 a
Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-21-006285
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:4/30/2021
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) 50 NORTH RD
Owner or Tenant Patricia Khochadorian Telephone No.
Owner's Address
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- ❑ 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 Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
p Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0
Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
y No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Eau' al
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunication. iNo.of Devices or i ui e �`
OTHER: \S" e '
Attach additional detail if• sire , r as-✓e ed by dte.7nsilecl6r of Wires.
required bymunicipal policy.)Estimated Value of Electrical Work: (Whenq P p y.) y� O;\ �0,
Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon comp ,fin < V,
INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless'+ licreh°5ee �� ✓S r., . `
v
provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certi114 thaltsttch ' '
coverage is in force,and has exhibited proof of same to the permit issuing office. N
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
UtICI. 6.0(z(
. •% CO mmanwealidt of rfi?oasaelutsalls
r •, "M 7 Permit No. C;i1A -( -1-?...*
si
_ ., ,, Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS 'ERev. bal.} (te,,
f _ ,
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
Ali work to be performed in accordance with the Massachusetts Electrical Code(ME .527 C1R 1211(1
(PLEASE PRINT IN INK OR TYPE ALL INFORMATIO) ) Date: Y oq dy
City or Town of: /2"_cti T'ti To the Iiispecier of Wires:
By this application the nct(givcs nonce of his or her intention ti-...perfow the electrical tis,ark described belovi
Location(Street St Number) s6 N cw_.-T-i? 0---i. .
Owner or Tenant P4'7 , I et_cc' ki , ,....4 0,/I Telephone No. 67ef-41V/_. >,d.j
owner's Address c.5-0
Is this permit in conjunction with a building permit': Yes Ell ND i._,,.7'. Wheel:Appropriate Box)
Purpose of Building 02'S/ c=1"--pi c e--) Utility Authorization No.
Existing Service O-42.i Amps /a:A oli/OVolts Overhead[ Uudgrd 0 No.of Meters /
New Service Amps ' Vats- Overhead 11 Undgrd El No.of Meters
Number of Feeders -.,. 4 AnSinCitY .eV/A
Location and Nature of Proposed Electrical Work: 6 1/e- 64 -at E---c- /---=on_ C,--rii, /----7-60.e- pt,cz
= E Completion of the following table May be iirrived ln,the Inspector of Wires.
1No.of
0 f Recessed I. -- 'foal
c
.-- IN o ' 'i u u. :, • .i i No-of Ceil.-Sesp.(Paddle)Ffifr. 1Transformers KVA
No.of Lunibtaire Outlets
t 0 No.of Hot Tubs Generators K%A
0 Above I-1 hi- 0 No.of Emergency Lighting
w No.of Luminaires
713 ;I Swinulliag Pool grad. I--J grad. Battery Units
4.
u =
to 0 No.of R ,F0'., °Bow 1 No.of OR Burners FIRE ALA.RMS No.of Zones
, -
1 ti,..o t.'tertian
No.of Switches No.of Gas Burners Initialing Devices
Total
No.of Ranges No.of Air Coad. No.of Alerting Devices
Tons
Heat Pump I Number I Tons KW ,.of Self-Coubdoed
No.of Waste Disposers f, Totals:! Detedk a/Alerting Devices
,
No.of Dishsvosbers SparefAra tit:Oleg KW Local 0 M ' L I 1,.r
No.of Dryers Heating Appliances KW ecurity Systa:ns:*
No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaten ICNV
Si2ns Ballasts No.of Devices or E i nivalent
, e- ommuntrations '
No.Hydromassage Bathtubs f No.of Motors Total HP I No.of Deriets or • t
OTHER: I
Attach additional detail if desired,or as required&the Inspector of Wires.
Estimated Value of E . al Work: ''---TC) (When required by municipal policy.)
work tc.Sum. I--/ f:". laspcctg-os to he req-utsigd in:v.:col-dance with MEC Rafe 19.and upon conlIdeUma.
INSURANCE COVERAGE: Unless waived by the OV.W,no pcitait 1ir the perfmnmeQ of eke-meal work may issue,=less
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 ki BOND CI OTHER 0 (Specify:)
I eertifr.under ihe • : • . ;•r . , , -, that the information en this application is true and complete.
FIRM NAME: 7 Llefs Lane LAC.NO.: ii 7111
South Yarmouth, MA02664 Signature ,
Licensee: i_oz2 .0.. ) ,„44,4,..11 „;..,./._.-,...---
'9 LIC.NO.:
(If applicable,enter"MireGNentVel Bus.Tel.No.; '7 d--I 6-1 a s.r'ri
Address: Alt.Tel.No.:
tPer NI.G.i.. .-:, 147, --- 57460. --ecinity;kink requires neontroent of Public Safety"S"Licence Lie No.
OW ER'S 1 NSU R A NCI'AA IV ER: i art aware Ilia:1.1-1;1 h:,•.-uv,.::-..i.,k.z ii..,e-ilf.21.,,th,:lisilitii!, .IngnaiCt cot.Ciag,:
required by law. By my signature below,I hereby waive this requirement. I am the(cheek one)Li owner 0 owner's agent,
Owner/Agent
Signature Telephone No. PE'RMIT FEE:S