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Home My WebLink AboutBLDE-18-001012 Commonwealth of Official Use Only . or/ . , E Massachusetts Permit No. BLDE-18-001012 • BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.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 PRI/VT IN INK OR TYPE ALL INFORMATION) Date:8/22/2017 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) 10 MONOMOY RD Owner or Tenant CASHEN SANDRA TelephoneNo.- Owner's Address 10 MONOMOY RD, SOUTH YARMOUTH, MA 02664-1974 Is this permit in conjunction with a building permit? Yes 0 No ❑ (C' iiip, ro.ol;i e i .O Purpose of Building Utility Authorization No. 1 I a Existing Service 100 Amps Volts Overhead 0 Undgrd 0 .9' : to ' A ew Service 100 Amps . Volts Overhead 0 Undgrd 0 , . J84r''p Number of Feeders and Ampacity U Q Location and Nature of Proposed Electrical Work: Replace distribution panel > 9 Completion of the following table may be waived by to/of Wt( No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of oral Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- 0 No.of Emergency Lighting grnd. grnd. Battery Molts , 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 Ton. No.of Waste Disposers • Heat Pump Number Tons 1 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 Eauivalent 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 HP Telecommunications Wiring: No.of Devices or Eauivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) II 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 ❑ 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: Michael W Cashen Licensee: Michael W Cashen Signature _ LIC.NO.: 13422 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:10 MONOMOY RD,S YARMOUTH MA 026641974 Alt.Tel.No.: , *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"5"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:$50.00 r' �... l.ammoruu of/r/aseee f1S Official Use Only &a,..,,-......-7._ { .� P1Le ( o fa... tPermit No. . -!1 -L.Jepe+(menE o enrich +. r • -_?{_ Occupancy and Fee Checked BOARD OF ARE PREVENTION REGULATIONS • . I/07j . (leave blank) ..S, . APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK AU work robe performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.D0 (PLEASE PRINT ININKORTYPE ALL INFOR&L4TI01, Date: S-.a(-/ 7 City or Town of: YARMOUTH To the Inspector of Woes: . By this application the tmdersigned gives notice of his or her intention to perform the electrical work described below. • Location(Street&Number) le) 01OACY12OY al.- St Yo fytlod+Ct AAA- 02Ckc( Owner or Tenant .c-)01.4,-5,,- (' LA-44._ Telephone No. Owner's Address �' Is this permit in conjunction with a building permit? Yes El No (Check Appropriate Box) ' Purpose of Building I OOSC Utility Authorization No. Existing Service bo Amps lao/aqn volts Overhead Q Undgrd D" No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity • Location and Nature of Proposed Electrical Work. . , , , - ec ,O /- • '14' 67,th- 'e At/ 0/ natal Ma ----..-. • '/,p. •111*TU. . "`"74-y_Le- Completion ofthefollaw6«table may be waived by the Inspector of Wires. Q No.of Recessed Luminaires No.of Cer7.-Susp.(Paddle)Fags No.of Total LU t`-' No.of Luminaire Transformers (CVA Outlets No.of Hot Tubs Craentnrs • (CVA a N No.of Luminaires (Swimming Pool Above ❑ In- I a of Lmergency l.bhang �' .-a 'rad- ern& ❑ 'Bather! www C•1 1.1' I No.of Receptacle Outlets No.of Oil Burners !FIRE ALARMS INo,of Zones CO '� V CO �� No.of Switches No.of Gas Burners Na of Detection and W -. InitiatmfDevices n , No.of Ranges IND.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers IHeatTobIs: e?ump I Number ITons I ICW INDo.of Stion/Aletf-Containned ttterti ?Devices No.of Dishwashers Space/Area Heating KW' Local Municipal ❑Connection otter No.of Dryers (Heating Appliances KW Security SrDpstenss:• No.of Water ICW INo.of No.of Data aWiring:ices or Equivalent Heaters Ballasts Sins No.of Devices or Equivalent No.Hydromassage Bathtubs INo.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER Al y 00 Attach additional detail if derired or as required by the Inspector of Wire:. Estimated Value of Electrical Wort` � r (When required by municipal policy.) Work to Start g a 0 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 tmiess the licensee provides proof of liability i ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove 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 erjury,that the information on this applications true and complete. FIRM NAME: Afea4.e / (,f 1`7eCbtte4fri LIC.NO.:/g92 � Licensee: /�11L�fal 64-56—______ eSignatnre�� LIC.NO.: at-applicable, enter"exempt"in the license number line.) l Address: /553 CZeaes a be a yea 64 Bus.TeLNo.:1/ s'/d- , 0 �� 5 Alt TeL No J `Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. QOWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally 5 required redp gene. ByBy my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agent. Signature Telephone No. I PERMIT FEE: $