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Home My WebLink AboutBlde-19-003540 r or Commonwealth of Official Use Only tiEPermit No.-BLDE-19-003540 it _ Massachusetts `"* 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:12/11/2018 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 des below. Location(Street&Number) 41 HAWTHORNE RD `�IN (OIL Owner or Tenant DRISCOLL RICHARD Telephone No. Owner's Address DRISCOLL MELISSA, 16 TOLMAN ST, DORCHESTER, MA 02122 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Three season room. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 4 No.of Ceil:Susp.(Paddle)Fans 1 No.of Total Transformers KVA No.of Luminaire Outlets 2 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 7 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/Alertine 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 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: Charles G Munroe Licensee: Charles G Munroe Signature LIC.NO.: 18520 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 19 E COMMERCIAL ST,WELLFLEET MA 026677451 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 *Jcft' /c ' i/ �/' •.'" o i/A' 7/jo �r9 r ^ I 1 l.arnntonmsa o//ila.4.sactue4sflts Ofer Use Only u+ r 2sp i girt:Services Permit N < 3 S 1 o arfmanf o f 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(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /t i / '( // f City or Town of: YARMOUTH To the Inspector of Wires: By this application the µndersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) 7/ 1.c ',,r,k�ea /2 d Owner'or Tenant J j) re,6 ge, Li, Telephone No.4'a>s-may!-374/,Z Owner's Address Is this permit in conjunction with a building permit? Yes V No ❑ (Check Appropriate Box) Purpose of Building 3,.j �,e0 yi) ie%0 ei,..t, Utility Authorization No. V Existing Service Jo Amps /2.6 I Z(.)p Volts Overhead L.7 Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion f the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires y No.of CeiL-Susp.(Paddle)Fans No.of Total 4Transformers KVA _ No.of Luminaire Outlets No. of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting . - grad. ^t tad. Battery Units No.of Receptacle Outlets "`7 No.of OH Burners FIRE ALARMS INo.of Zones No.of Switches 3 No.of Gas Burners 'Ho.of Detection and Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pomp I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local D Municipal 0 �7 (- Connection No.of Dryers Heating Appliances , Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Heaters KW Wiring: 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: j Z '7//g Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: Unless waived by the owner,no permit for the perfo rmance 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE g BOND 0 OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: �,,/� LIC.NO.: Licensee: e R.d_.c, `�6 S 6.. i./.t.)A.a£ Signature c -I. ` LIC.NO.: S (If applicable,enter"exempt"in the license?Timber line.)_ . Address: /4 �,Cnvv%,y„,.,e,yL r, t�j ��L�� - 1 c)Z g 6 7 Bus.Tel.No.: S l ' Alt.Tel.No.:�S_ w. J *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. �c OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage n— ormally S required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent d Signature Telephone No. I PERMIT FEE: $ I