The URL can be used to link to this page

Home My WebLink AboutBLDE-19-005789 4 ii Commonwealth of Official Use Only i Massachusetts Permit No. BLDE-19-005789 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:4/16/2019 City or Town of: YARMOUTH To the Inspector of Wires: V--v / 77 I �RPr By this application the undersigned gives notice of his or her intention to pertors.111freiectncal work described b �� Location(Street&Number) 17 STATION AVE ` t. A A M l l O Owner or Tenant KENEFICK GARY elephone No. Owner's Address KENEFICK KAREN, 1879 BRICES CREEK RD, NEW BERN, NC 28562-8505 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: Replace washer receptacle. 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 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. Total No.of Alerting Devices 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 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 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 perjuty,that the information on this application is true and complete. FIRM NAME: DARNELL CAULEY Licensee: Darnell Cauley Signature LIC.NO.: 11662 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:54 CAPTAIN BESSE RD, S YARMOUTH MA 026642805 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: $50.00 OA (l 1 c f 1\f) 4 c l9e I .14 /� tt,, Conrnwnu ea[tYi o`Maeeachud ,, OfficialUs On Y,/7 a rose ..firs S Permit No. — � 9, 1. x� -• •p �of oe+viet6 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) 3 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Li -I I -J 1 City or Town of: sy 6,-C COW) To the Inspector of Wires: By this application the undersigned gitfes notice of his or her intention to perform the electrical work described below. Location(Street&Number) 11 S laVJ'NI A q e Owner or Tenant T0.I.k Va- Cc,M t16 Telephone No. SO$-344-771 I Owner's Address Is this permit in conjunction with a building permit? Yes 0 No Ei (Check Appropriate Box) Purpose of Building 1-1-0`(Yl - Utility Authorization No. Existing Service 9.0D Amps I 010/ Alio Volts Overhead CO Undgrd 0 No.of Meters 1 New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity "� Location and Nature of Proposed Electrical Work: (40GEC-e- Wr.5hec- pus yV Completion of the followinKtable nra'be waived by the lncfor of Wires. otal No.of Recessed Luminaires No.of Ceil.� (Paddle)Fans No.of TVA u� Transformer KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. Li Battery Units N No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones C No.of Switches No.of Gas Burners No.of Detection and Initiating Devices 0 No.of Ranges No.of Air Cond. Tons No.of Alerting Devices I n No.of Waste Disposers Heat) Number Tons _KW Notals: Det of Self-Contained V J Munici Alerdisgpevices No.of Dishwashers 5pace/Area Heating KW Local 0 Cyyo��ttneenmmection ❑ Other No.of Dryers Heating Appliances KW SecNo 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 HP Telecommunications Wiring: y age No.of Devices or Equivalent f. o MOTHER: f+ Attach additional detail if desired,or as required by the Inspector of Wires. 0 _ Est hated Value of Electrical Work: (When required by municipal policy.) vu'� " ~ Work to Start y-it-J4 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless ,gyi U T 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 (p BOND 0 OTHER 0 (Specify:) '`"- . ` Tcirtify,under the pains�a"(nd nanities of perjury,that the infontwdon on this applka ion is true and compete. FIRM NAME: Da C nzI l��J� LIC.NO.: I k 6 Licensee: —Darnell. ('� e 1Q, / Signature Mannar LIC.NO.: (If applicable,enter"exempt"in the icense numbg line.) Bus.Tel No.: Address: 5/1 Ca )-eu \ es9e vo Soy:t'h y r Ufh' AAA adG6 y Alt.TeL No.: 77u-3 53-6546 *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)0 owner ❑owner's agent. Owner/Agent PERMIT FEE:$ 5 0—I Signature Telephone No.