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Home My WebLink AboutE-18-2444 • Commonwealth of Official Use Only c taiti Massachusetts Permit No. BLDE-18-002444 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:10/25/2017 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) 82 INDIAN MEMORIAL DR Owner or Tenant BROOKS ROBERTA M Telephone No. O Owner's Address 82 INDIAN MEMORIAL DR,SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Ch rop�V Purpose of Building Utility Authorization No. 0 Existing Service Amps Volts Overhead 0 Undgrd 0 oySA a A, New Service Amps Volts Overhead 0 Undgrd 0 N .411.. e i rAlr A, Number of Feeders and Ampacity 7, Op - '1 Location and Nature of Proposed Electrical Work: Remodel kitchen Completion of the following table may be waived by rjQe tor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of tal Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above a In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 6 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 'Pons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local ❑ 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 Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total IIP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail rfdesired 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: Vincent D Mahoney Licensee: Vincent D Mahoney Signature LIC.NO.: 10123 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:35 FIELDWOOD DR,SAGAMORE BCH MA 025622200 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 — • Cammaruuaaak o`rr/asdachawrtto iWV31 � �` IS Permit No. zm� Therirmanto`Jn Jirorcu SI.- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(AEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: City or Town of: 1{'i,(�i iamb// To the Inspector of Wires: By this application the undersigns gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) f,2 /M,f ,r/ , icki CT L bi.P Owner or Tenant Kl in/ R WY ey Telephone No. Owner's Address !! Is this permit in conjunction with a building permit? Yes No (Check Appropriate Box) Purpose of Building gnat Cly egiteO/)tt U '. uthorization No. Existing Service MTP Amps ) /2140 Volts Overhead 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: mpg- k I1m../ fh G00 er Completion of thefollowingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Total Transformers KVAVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Na of Luminaires SwimmingPool Above ❑ lo- ❑ No.olEmergency Lighting grad. grad. Battery Units No.of Receptacle Outlets 6 No.of Oil Burners FIRE ALARMS No.of Zones Na of Switches Na of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons Na of Waste Disposers Hat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers I Space/Area Heating KW Local 0 Coeeccdoln 0 otherNo.of Dryers Heating Appliances KW SecNatyot Systems:* es or Equivalent Devic No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Na Hydromassage Bathtubs Na of Motors Total HP Telecommunications Wiring: Na of Devices or Ettulvalent_ OTHER r�ll Attach additional detail‘desired or as required by the Inspector of Wires. Estimated Value of Electrical Work. oC(66(/ (When required by municipal policy.) Work to Start: I a-2Y-17 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' ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) • I certify,under the pains and penalties of perjury,that the Information n thls application Is true and complete. FIRM NAME: LIC.NO.:/6)g 3 Licensee: vfl[Ct9v7' fringOlt/ Signature LIC.NO.: (If applicable egter"exempt" in(he li me number line.) Bus.Tel.No.�. Address: Eib J 27rt ROKif MP- 0,1,%2. Alt TeLNo.: *Per M.G.I..c.147,s.57-61,security work requires Department of Public Safety"5"License: Lie.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)0 owner ❑owner's agent Owner/Agent Signature Telephone No. I PERMIT FEE:S