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Home My WebLink AboutBlde-20-001336 Commonwealth of Official Use Only E Massachusetts Permit No. BLDE-20-001336 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:9/10/2019 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) 19 HEMLOCK PATH Owner or Tenant PERNICK RUTH B Telephone No. Owner's Address 4 LILAC CT, NANUET, NY 10964 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: Repair service from panel to weatherhead. Install 4 receptacles&3 switches. 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 4 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 3 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 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"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: $50.00 ►v Commonwealth of Ma�aehudslfs - Official Use Only .-.,- i J. - �-i� ��_-t� t 6/.�cr.J •Permit No. ( 2 ,-' 1 33(-P ' .\._- 1 L I i 1T- , arurfYILL T cruised �, _. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS s �. ..• '�„ Rev. I/07] (leave blank) f` APPLICATION FOR_PERMIT TO PERFORM ELECTRICAL WORK 4 . 1 All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 t;,�,: w z {, (PLEASE PRINT IN INK OR TYPE ALL INFORMATION 1 ,0 YARMOUTH) Date: g_/v 1f . cn Cityor Town of: To the Inspector of Wires: r �--- T,.-'By this application the undersigned gives notice of his or her intention to perform the electrical work described below. -- -----�--'Location (Street&Number) / / ty 6.4 6oc k MTh Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No ,- (Check Appropriate Box) Purpose of Building (t71oU$e Utility Authorization No. Existing Service /QE) Amps /a0 /c 'O 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: re, Au- Se ff!< 2(0e-e fa,,,-t. 1,r([Sf4? ?ASV I -ft, wPh tin/A cd ^ 7:v4f/9l/ a rte.) 0 vie_1S ,, - Completion of the followingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cet7.-Snsp.(Paddle)Fans No.ofTotal LP Transformers KVA E.. No. of Luminaire Outlets No.of Hot Tubs Generators KVA No,of Luminaires Swimmin Pool Above In- No.of lvmergency Lighting g erred. ❑ rind. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS JNo.of Zones No.of Switches No.of Gas Burners No.of Detection and Co Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices (..,,> No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of DishwashersMunicipal Space/Area Heating KW LLocal❑ . ❑ Other Connection 1 No.of Dryers Heating Appliances KW Security Systems:* C. No.of Water KW ofNo.of Devices or Equivalent No.of No. Data Wiring: 0 Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - OTHER: No.of Devices or Equivalent 'S vAttach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work /52 c) (When required by municipal policy.) t. Work to Start: 9-'-/- 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. CZ CHECK ONE: INSURANCE RI BOND 0 OTHER ❑ (Specify:) I certify, under the pains and penalties of erf ury,that the information on this application is true and complete. FIRM NAME: /VeVt4-1/ f-5f,G�/tCiuy LIC.NO._�/5�� Licensee: ,4 ,e4 j '7 �,f y` Signature LIC.NO.: (If applicable,enter "erempt"in the license number line- < Address: iS33 r•DC/e'a/e.5 L/�le�i�A AAA a _•--Bus.Tel.No.:_77� j "Per M.G.L. C. 147,S.57-61,securitywork requires �7 ma's Alt.Tel.No.: Department of Public Safety"S"License: Lic.No. Q OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S 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: $SD—