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Home My WebLink AboutE-18-1573 f Commonwealth of Official Use Only l � , \ Massachusetts Permit No. BLDE-18-001573 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/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:9/19/2017 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) 95 GREAT WESTERN RD Owner or Tenant OROPALLO MARYPAT K Telephone No. Owner's Address 95 GREAT WESTERN RD, SOUTH YARMOUTH,MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Che Appropriate Box) Purpose of Building Utility Authorization No. 0 /\ Existing Service Amps Volts Overhead ❑ Undgrd `ii,'Glite ten New Service - Amps Volts Overhead 0 Undgrd Number Feeders and Ampacityopose ^ 0 Location and Nature of Proposed Electrical Work: Install generator and washer/dryer receptacles Completion of the following table ng Inspector- Inspector ofWires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of VVV O Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators 1 AOKVA No.of Luminaires Swimming Pool Above 0 In- 0 No.of Emergency Lighting e8 grnd. grnd. Battery Units No.of Receptacle Outlets 1 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. .To al No.of Alerting Devices 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 1 Heating Appliances KW Security Systems:" No.of Devices or Eauivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eouivalent OTIIER: Attach additional detail Vdesired,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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Arthur P Doherty Licensee: Arthur P Doherty Signature LIC.NO.: 17197 (If applicable,enter"exempt"rn the license number line.) Bus.Tel.No.: Address:372 YARMOUTH RD,HYANNIS MA 026012043 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 0 owner's agent Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 �tt ct4 4)Ce zT �elz-. Gam- 9/4 /7 cfiPy ��• UNDer5coUs°D ;�.(,5Pe-aMi3 &CDAJecae' t/ 5e-pr Zo,XA/7 cc, mrr caS of Ps PertNo• apartment oI fir.S'�r BOARD OF FIRE PREVENTION REGULATIONS OccupancyandFe blank Checked Rev. 1/07) �— (lezve blank) APPLICATION 'FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electical Code(MEC),$27 CMR 1200 (PLE,4SEPR.INT WINK OR TTPE ALL INFORAL4T70N) Date: C •-' • City or Town of: YARMOUTH By this application the ersi ed To the Inspector of"fres: 91\ tmd ;vas notice of his or her intention to perform the electrical work desrnbed below. • Location (Street&Number) 9S" GreRT 14.1-e_sT«r n RD Owner'orTenant SI/U Pf1T (22OpA/.Lo Telephone No. iN Owner's Address // > --� • Is this permit in conjunction with a building permit? Yes E No I•, z Purpose of Etnldtng _. (Check Appropr atn Boz) ,u t./i%rti utility Authorization No, w Existing Service Q IInd.rd❑ No.of Meters 0 ^ S Amps / Volt Overhead a • • � New Service Amps / Volt Overhead _ E-71IIadgrd 1:3 NO.of Meters rn Number of Feeders and 4mgsc ty W .., Location and Nature of Proposed Electrical Wort: ;r• o 15-1 Ou /c'(s ;tt) Ct.//n.c z 6e n�,r»To- A-- '- cam. . . r . Dc e� LUci) t - -__ - _ Completion of the following table mcy be waived by the lamer-tor of Wires. C2: No.of Recessed Luminaires No. of CeR.-Snsp.(Paddle)Fans ITransNo•of Total m formers ICVA No. of La Outlets No.nfHot Tubs 'Generators • 1;'VA. ' No. of LuminairesSwirnt„ing Pool Above ❑ al- ❑ Nc.or inserg-Learyl.tanune - Asnd. arnd. (EarvUnits No. of Receptacle Outlet . No.of on Burners FIRE AI-SEEMS JNo.of Zones No. of Switches No.of Gas Burners No.oiTletecn nd No.of Ranges atitio�Daevices Na of Air Cond. Totes No.of Alerting Devices • Totes No.of Waste Disposers Heat Pump I Number I-Tons IKVJ 'No.of Self-Contained - Totals: lDetec'tionJAlertine Devices No.of Dishwashers Spate/Arta Heating KW' I,�Q oaneetiCrinnZa n - on 0 Oda No.of Dryers Heating Appliances Security 5 ems:: No. of Water No.of Devices or Egnivalent Heaters KW No. of No.of Data bluing. Sins Ballast No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecomm evices ns wind OTHER No.of Devices or Equivalent • Attach additional detail if derired or to required by the Inspector of Wires. Estimated Value of Electrical W o Work to Start (men required by municipal policy.) to be in C Rile INSURANCE COVERAGE: Unless waived by the owners p�t�cthe ee with MErmance of eelectrical work ay,and upon ti sn the licensee provides proof of liability insurance incluriing"completed operation"coverage or it substantial equivalent. These undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND ❑ OTHER 0 (Specify° I certify,raider the pains and penalties of perpuy,that the information on this appttcaton is true and complete. FIRM NAME: Urry.4i0,E._ Flcc.TrTc_r_I Carrree.etonrS LIC NO.: !sc7 Licensee: i Mti � t� / Signature C.n0 ...------ O.: (If applicable,enter exempt"in the license number lime.) LIC o.: Address. . • ; i D Bus.TeL No.:_______---- A � - r t rn . /Z _ • Alt TeL No. / N•9 j `Per 1vLG.L. c. 47, s.57-61,security w. requires Department of Public Safety"S"License: Lic.No. (674 . - OWNER'S INSURANCE WAIVER: I am aware that the licensee does nor have the liability insurance coverage normally r quired by law.r By my signature below,I hereby waive this requirement I ern the(cheek one)D owner 0 owner's agent. 1 Signature. Telephone No. 1 PERMIT FEE: S