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Home My WebLink AboutBLDE-18-006173 .440 - Commonwealth of Official Use Only Massachusetts Permit No. BLDE-18-006173 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:5/2/2018 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 described below. Location(Street&Number) 246 OLD MAIN ST Owner or Tenant SMITH KEITH E Telephone No. Owner's Address SMITH ERIN M, 246 OLD MAIN ST, SOUTH YARMOUTH, MA 02664 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: Remodel kitchen. 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 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 ❑ 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Jesse J Mackenzie Licensee: Jesse J Mackenzie Signature LIC.NO.: 13111 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 10 BYRON LN, S YARMOUTH MA 026644156 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 2Lt1 C 3(f8 'took 8(7211q0------ 09i1 tA.A V*i lF fey, k,i . \ Commonwealth o/t'//a achtedetts Official Use Only I._ j s Permit No. s+� _ _ Apartment o erv%us 1 Occupancy and Fee Checked 77 CV 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: ,s Q7-/a City or Town of: YARMOUTH To the Inspector of Wires: By this application the µndersigned gives notice of his or her intentio o perform the electrical work described below. Location(Street&Number) . L 16 0 AO /1/ / /A) W Owner or Tenant 00/0 2 I• K'Z y 4/I Telephone No. rq3 367^s'6' r` `,, r Qkvner's Address ,t t-/6 Q-to cvmgAil v' Is thi " s permit in conjunction wit a building permit? Yes �—y� No= 1a ❑ (Check Appropriate Box) ' Purpose of Building ,*IiCe Ale"- Utility Authorization No. ,- Existing Service Amps a a` /,?e.t Rye,Volts Overhead E Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1<1 jclfe t/ l d AO LC.il.9/c ee-/e i s i /mot ' Completion of the following table may be�e the Inspector of Wires. No.of Recessed Luminaires No.of CeII.-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 - grad. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.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 No.of Waste Disposers Heat Pump I Number Tons KW No.of Self-Contained Totals:f-' "�' Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKWMunicipal Local❑ Connection ❑ er No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KWNo.of Data 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:S.,f le 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. I CHECK ONE: INSURANCE ZVBOND 0 OTHER 0 (Specify:) I certify,under the pains and p7, s of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: 13///—_e Licensee: ,IBC :01.e2e Signature (If applicable,enter"exempt""in the license number line.) eMr� �� LIC.NO.: E us.Tel.No.: 7 — 79 ] ,,,1 `Per M.G.L. c. 147,S.57-61,security work requires Department Public Safe lt.Tel 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 0 owner's a:ent. Owner/Agent 0.1 Signature Telephone No. PERMIT FEE: $