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Home My WebLink AboutBLDE-23-004188 Commonwealth of Official Use Only r~ 1 P ? t' Massachusetts Permit No. BLDE-23-004188 � BOARD F 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:1/30/2023 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 beloyr� r�_ r6.—j Location(Street&Number) 50 WOOD RD ( L t. YJKC-J��if/�j Owner or Tenant DAVID KRAPF 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: New addition. (Lights&receptacles) 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 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 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent 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: Ronald J Cormier Licensee: Ronald J Cormier Signature LIC.NO.: 987 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:82 KELTON RD,ASHBURNHAM MA 014301320 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: $75.00 _,_,1/4., __,Ici 24 vz:z1-2.3 r_e_..., kc ram- C- t (i5 a. .-:a '1_-•• F. C E 1 V Elio eaClh o/Ma�eac4u.4. Only Official Use I, lill tt.p. ., Permit No. 7 --4( 66 �' JAN 2 7 202 pa tnenl of.five Serutced ,�;.f� Occupancy and Fee Checked .�.1+ ' BOARD OF FIR 'REVENTION REGULATIONS [Rev. 1/07] (leave blank) BUILDiNU =DE_PARTMENT A "-" - - _• • - ' 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 2- ? G :2 3 City or Town of: Se f A //p-m ,;F t 1) To the Inspector of Wires: By this application the undersigned gives notice of \ of his�or her intention to perform the electrical work described below. Location(Street&Number) 4' //,/p,,,,,( r a ✓j et. Owner or Tenant .2/ 1')<Y( k , /1 r k )f Telephone No. 5',7L'. _cf-sr0 f 5 Owner's Address Is this permit in conjunction with a building permit? Yes jA. No E (Check Appropriate Box) Purpose of Building dwelling Utility Authorization No. Existing Service 100 Amps /,,?.41/ 4'17Volts Overhead Undgrd l g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: u6 i (2.t J , Li g 0 r- a l J�t j G 17--k4 c k P 0 r [J2 .°f)L)it- tOr C , 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 No.of Switches No.of Gas Burners No.of Detection and Initiating Devices Tot No.of Ranges No.of Air Cond. Tons No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local El Connection Connection ❑ Other uriNo.of Dryers Heating Appliances KW Sec No.of Devi es or Equivalent No.of Water Heaters KW No.of No.of Data Wiring: 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: 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 E BOND ❑ OTHER E (Specify:) I certify,under the pains and penalties of perjury,that the information on t • plication is true and complete. FIRM NAME: CORMIER ELECTRICAL LIC.NO.:MR 987 Licensee: Ron Cormier Signature ' ,� LIC.N E32333 (If applicable,enter "exempt"in the license number line.) us (g78)827-5172 Address: 82 Kelton Rd *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.L cl 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 Signature Telephone No. PERMIT FEE: $