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Home My WebLink AboutBLDE-23-005952 '4. _6 �I5 Commonwealth of Official Use Only . "t.:1,b 4) Massachusetts Permit No. BLDE-23-005952 F . 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:4/27/2023 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) 300 BUCK ISLAND RD UNIT 7F Owner or Tenant HELAINE GULERGUIN 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: Remodel first floor(UNIT#7-F) 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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine 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 Siens 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: RAYMOND E LAFLEUR Licensee: Raymond E Lafleur Signature LIC.NO.: 16814 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:355 Old Jail Ln,PO BOX 253,Barnstable MA 026301426 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 ) ' -1, baCCI elr 5 1 i (23 k= ttkork._ q (Irc(44 . ECEIVED_ .. Y.. ...•_.___ o ,nluaa[th ol--///aeeachuf Official Usc Only !'" vtPR 2 6 �� ♦parfn+snf ol,} s Permit No. Z�—� ��/ 'I'I $ Occupancy and Fee Checked • Q_ARQ Q ' PREVENTION REGULATIONS Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM All work to be performed in accordance with the M ELECTRICAL ode(MEC),527 CMR 12.00 WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:City or Town of: �� ,r�mc� ;-dine sP I oLac,: o 1.a3 es: By this application the undersigned gives notice of his or her intention to perform the lectrical work described below. : r :: Number) '�t GL\e Telephone No. C, " 1 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No KI Purpose of Building .i - • -��.d•_1T L�� . (Cheek Appropriate Box) Utility Authorization No. Existing Service.10..(1 bd Amps / i A0 Volts Overhead❑ Undgrda No.of Meters j New Service Amps / Volts Overhead Number of Feeders and Ampacity ❑ Undgrd ❑ No.of Meters Location and Nature of Proposed Electrical Work: (�3{T y vl "i Corn letion o the ollowin table m be waived b the Ins ector o Wires. lb No,of Recessed Luminaires Q✓ No.of Ceil.-Snap.(Paddle)Fans °•° ota �� No.of Luminalre Outlets Transformers KVA No.of Hot Tubs Generators KVA -4 No,of Luminaires Swimming Pool Ve ❑ n- o.o Units cy g n rnd. nd. ❑ Batte Units g ":;z1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones "• No.of Switches No.of Gas Burners o.o etechon an t No.of Ranges Initiatin Devices No.of Air Cond. °� No.of Alerting Devices No.of Waste Disposers Tons eat ump um er ons o.o e ontarn Totals: "" Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW al❑ umc p Connection ❑ thher No.of Dryers iY Heating Appliances KW ecunty ystems: o.o ater ° ° No.of Devices or E uivalent Heaters KW ° ° Data Whin Si s Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommun ca ons rmg; OTHER: No.of Devices or E uivalent Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electri I Work: Work to Start: �- (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RA E: 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 gl, BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete, FIRM N• Licensee: di i/} _• = LIC.NO.: j y� .1 ignatune "IMIMPF i'-I (If applicable,enter empt"in the license number line) %' z NO.: Address: , Bus.T Tel el.No. i ��It{ Alt.Tel.N *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 Licensee does not have the liabilityLin.No. required by law. By my signature below,I hereby waive this requirement. I am the(check on insurance coverage normally Owner/Agent ❑owner owner's a ent. Signature Telephone No. p PERMIT FEE: $ i