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Home My WebLink AboutBLDE-18-007023 Commonwealth of Official Use Only 1Odiriat NI E'^`'7! Massachusetts Permit No. BLDE-18-007023 ,,, BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.1/071 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:6/11/2018 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) 1 HISTORIC BROOK RD Owner or Tenant MENDOSA DEBORAH V Telephone No. Owner's Address 1 HISTORIC BROOK RD, SOUTH YARMOUTH, MA 02664-4334 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 central NCZia Completion of the following table may be waived by the Inspector of Wires. v-, No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA .tom No.of Luminaire Outlets No.of Hot Tubs Generators KVA JI No.of Luminaires Swimming Pool Ab0 In- No.of Emergency Lighting grnove d. grnd. 1:1 No. rrp- Units No.of Receptacle Outlets No.of OB Burners ,FIRE ALARMS No.of Zones 41441 No.of Switches No.of Gas BurnersNo.of Detection and Initiating Devices ^ No.of Ranges No.of Air Cond. I l 'Tonso.of Alerting Devices �_ No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained a Totals: Detection/Alerting Devices 1 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 Data Wiring: Heaters Siena Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent 1 OTHER: �1 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: Stephan M Wolfe Licensee: Stephan M Wolfe Signature LW.NO.: 21259 (If applicable,enter"exempt"in the license number line.) Bus.TeL No.: Address:59 MEADOW ST,FRAMINGHAM MA 017013540 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$7100 cij e (8('0 1i- & „/ c am Officialf� Use Only � of Permit No D" ' GQeas3 �"=�� ccyy,, ee77 ��aa ,'tI•�E 1Jspartnunt of Jiro Jirvked 3i€ems ' Occupancy and Fee Checked h BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07 (leave blank) 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:5/30/2018 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)1 HISTORIC BROOK DRIVE Owner or Tenant DEBORAH MENDOSA Telephone No. 774-268-1699 Owner's Address SAME AS ABOVE Is this permit in conjunction with a building permit? Yes ❑ No 12 (Check Appropriate Box) Purpose of Building RESIDENTIAL Utility Authorization No. Existing Service_ Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service _ Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: WIRING FOR CENTRAL NC SYSTEM Completion of the following table may be waived by the Inspector of Wires. Tr No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Ta of Total Transformers KVA No.of Luminaire Outlets !No.of!lot Tubs Generators KVA No.of Luminaires SwimmingPool 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 AlertingDevices g 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 ❑ Other Connection No.of Dryers Heating Appliances KW Security yy Devices or Equivalent No.of Water No.of No.ofICW 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: 5/30/2018 (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 12 BOND 0 OTHER 0 (Specify:) I cert,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: MURPHY'S LIC.NO.:21259 Licensee: STEPHAN WOLFE Signature (If applicable,enter "exempt"in the license number line) GGG Bus.Tel.No.-50-760466o Address: 34 WHITES PATH SOUTH YARMOUTH,MA 02664 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 0 owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. Iis. . 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