HomeMy WebLinkAboutBLDE-23-004835 61?K\ Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-23-004835
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:3/3/2023
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) 4 RUNE STONE RD
Owner or Tenant PETER NELSON Telephone No.
Owner's Address 4 RUNE STONE ROAD, SOUTH YARMOUTH, MA 02664-1325
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: Wiring for hot tub&repair shorted wire in basement.
Completion of the following table may be waived by the Inspector of Wires.
No.of Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs 1 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
No.of Gas Burners No.of Detection and
No.of Switches Initiatine Devices
No.of Air Cond. Total No.of Alerting Devices
No.of Ranges Tons
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Alertine Devices
Municipal 0 Other:
No.of Dishwashers Space/Area Heating KW Local ❑ Connection
HeatingAppliances KW Security Systems:*
No.of Dryers PP No.of Devices or Eauivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Siens No.of Devices or Eauivalent
No.of Motors Total HP Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Devices or Eauivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
required bymunicipal policy.)
Estimated Value of Electrical Work: (Whenq p p y'
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 LIC.NO.: 11275
Licensee: Kevin A Cronin Signature
Bus.Tel.No.:
(If applicable,enter"exempt"in the license number line.) Alt.Tel.N o.
Address:7 Liefs Lane, South Yarmouth MA 02664
*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. rt;
Owner/Agent (PERMIT F>. 0 0(hF-� I
Signature Telephone No. 8
Qom. �,1-1)., 5 i ,
tt /Nomadism& 1 Official Use Only l
r�� - e i
n- /. c� Permit No_f
it
1Je4gins
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS !Rev. i/07] (lea,,,blank) I
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
AU work to he performed in accordance with the Massachwens Electrical Code I ME '''LIAR 12.00
'PLEASE PRINT IN INK OR TYPE ALL iNFORiLITIO<1�j Date: 3
City or Town of y 1/2- IV I Olt r1-1 To the inspector of Wires:
By this application the undersigi>eti gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) R ape brapE. zb
Owner or Tenant 09,e'Ie/ Pcl S*i f 5 Ae 1io /2''/ly Telephone No ( !7 0 C i` -C.0
Owner's Address / i7 its 771 Ilk fa P . / �-7
Is this permit in conjoin-Boa with a building permit? Yes ❑ No (Check Appropriate Box)
Purpose of Building pc,s /i Utility Authorization No. u f)
Existing Service / A) Amps j 7t_i I f J fulls Overhead Undgrd❑ No.of deters I
New Service Amps / Volts Overhead❑ Undgrd❑ N..of Meters
Number of Feeders and Ampacity / t)
Location and Nature of Proposed Electrica Work: a)
f . - 7L TU r PA'-G.: T CC
12 t i f S Nell-VD 3 t3 #9 ii l_i nT C- ,G-,fiL 1pc a a )—
Completion of the following table mar he waived by dieInepector of Wires.
addle)Fans No.of 7etal
No.of Recessed Lumivair es No.of Ced.-Susp.(P Transformers KVA
No.of l uminaire Outlets No.of Hot Tubs / Generators KVA
rgency
iu E No.of Luminaires Swimming Pool Above
e ❑ rya& ❑`Battery No.of Goi sn
Tru of pg Burners ;FIRE ALARMS No.of Zones
;, Y No.of Receptacle Outh:is
INo.of Detection and
No.of Switches No.of Gas Burners Initiating Devices
V = No.of Ranges No.of Air Coved. Total
No.of Alerting Devices
0
hd Heat Puy Nnmher Two _KW_ No.adiu Self-C.utaed
1\0 Disposers.of Waste Disp Totals: Detectiou/Alertog Devices
No.of Dishwashers Space/Area Heating KW Local 0 C e ech'oa ❑ Other
Heating Appliances KW urrk S}}-stems.;
No.of Dryers Nu`of Devices or&ph-silent
No.of Water KW, Data Whin' g:
1 Heaters s Ballasts No.ofDevices or Equivalent
T No.Hydroniassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent
to
S OTHER: 41 Lie G S Jw,ri 4 S Tyk r1V i i. 1 lrf4 r -t i2o re, t c c t-v i i
l4::,
et Attach additional detail if desired.or as required by the Inspector of Wires.
W t g Estimated Value of E I Work: g-O O (When required by municipal policy.)
. J " Work to Start: 3 Inspections to be requested in accordance said)MEC Rule I fl_and upon completion.
c a s 1L INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
2 o t Q the licensee provides proof of liability insurance including"completed operation'coverage or its substantial equivalent. The
-� proof of same to thepermit office.
Q ti�� undersigned certifies that such rnv a is in force,and has exhibited issuing
c cst CHECK ONE: INSURANCE BOND 0 Ot HER ❑ (Spe.ify:)
is I cetait,under the pains penalties of perjosyis awe and complete
7 rand ,that the drferattaeitatt on this 4P
o LIC.NO.: ild 71 R
FIRM NA;HE: �V t h l' h i •
Licensee: 'A-4 u h A. C rcn t h Signature Cr l3 LIC.NO.ay.i 71 L'
(If applicable.enter"exempt"in tke license number line) Bus.Tel.No.: 764 .'I.1 S-S 1
Address: Art.Tel.No.:
*Per M.G.L.c. 147 s.57-61,security cork requires Department of Public Safety'S"License: Lie.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hare 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, No.elephone 1 PERMIT FEE:a 1
Signature