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Home My WebLink AboutBlde-20-001590 Commonwealth of Official Use Only Permit No. BLDE-20-001590 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•9/23/2019 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 described below. Location(Street&Number) 183 EILEEN ST Owner or Tenant HENDERSON PHILIP C Telephone No. Owner's Address HENDERSON LAUREL A,41 SCOUT LN, NORTH ATTLEBORO, MA 02760-4706 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: Wire 3 season room. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 1 No.of Total Transformers KVA No.of Luminaire Outlets 3 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 8 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 Total 1 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 ❑ 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 aoa,,tt (1/130 9 KE �2 (Q) tot (-Fox Cr) r mil° B'Loc, ia5 t s °%•.4) Commonmsa of///addachuosf _Official Use On �� cc�'� cc�7� p „Official C ,n :1il= . )eparfinent o/.yirs Serviced Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked °�02 • ,`� [Rev. IV] (leave blank) t . . 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: G'J r-69 /1 9 City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) / 3` /L -':; Owner or Tenant P� l;i ! �i+ /P y _�- Owner's Address P P'i�c iC� Telephone No. _ 7�,2 Is this permit in conjunction ith a building permit? Yes � No ❑ (Check Appropriate Box) Purpose of Building � N�a.6 t 1,1 rc ,) . Utility Authorization N o. Existing Service ij d Amps h A)/, )Volts Overhead Q Undgrd C No,of Meters ) New Service Amps / Volts Overhead 0 Undgrd gr ❑ No.of Meters Number of Feeders and Ampscity Location and Nature of Proposed Electrical Work: L2 Completion of the follawing.table may be waived by the Inspector of Wires. - No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans i No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires 3 Swimming Pool Above 0In- No. tr l emergency Lighting _rod. trnd 0 Battery Units No.of Receptacle Outlets g No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Detection No.of Gas Burnersand Initiating_ating_ vices No.of Ranges No.of Air Cond. Tom h No.of Alerting Devices 1 No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: J Detection/AlertingDevices No.of Dishwashers Space/Area HeatingKWMunicipal Local 0 Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromass age Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail f desired or as required by the Inspector of Wires. Estimated Value of Electric Work (When required by municipal policy.) Work to Start: 7 „d 7 9 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C YE GE: 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 penoltws of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: ��,,nn --Licensee: G Q & e `,e4./rj) l)!. Signature` 1A�I-- I b LIC.NO.:..2.LI L_e (If applicable,.frt{ey_ezmot"in the license number line.) Bus.Tel.No.: Address: %�� _ c7jdt/dW,�./Z/G 6`4/G cre � a; 4-02 G`y Alt.Tel.No.- '.e//rj t70/ J "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 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 l Signature Telephone No. I PERMIT FEE: $