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Home My WebLink AboutBlde-19-000824 Commonwealth of Official Use Only E. Massachusetts Permit No. BLDE-19-000824 BOARD OF FP1E PRI /ENTION 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:8/13/2018 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) 2 CYPRESS POINT WAY Owner or Tenant DEVEREAUX JOHN D Telephone No. Owner's Address DEVEREAUX MICHELLE, 15 ROOKS RUN,GROTON, MA 01450 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appr b e Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 of New Service Amps Volts Overhead 0 Undgrd 0 o - •te / Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Kitchen remodel 1680Completion of the following table may be waive • t- of Wires. No.of 1 No.of Recessed Luminaires 6 No.of Ceil.Susp.(Paddle)Fans Transformers * 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 7 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons Tota No.of Alerting Devices 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 Siens 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: 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 eeoL564 e(t3(cg r I I ''// yyy�jj • I C,mmoncusaitls of//lassac tts Official Use Onl cc�`� n mil-_ - i Aparfmant of_sirs S'srviced Permit No. �-� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ;: ev. 1/07] eave blank --- APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL All work to be performed in accordance with the Massachusetts Electrical Code WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) (MEC),527 CMR 12.00 City or Town of: YARMOUTH To the Date: > pecto.r of Wires: • By this application the pndersigned gives notice of his or her intention to perform th electrical work described below. Location(Street&Number) / t S S tJ ,S�.i , yr�l? • Owner or Tenant Ch fit? ti Hal,ivv , Owner's Address �' �tt) Telephone No. Is this permit in conjunction with a building permit? Yes Purpose of Building N0 ❑ (Check Appropriate Box) g-.r,r' g_ yl r2i, Utth Authorization No. Existing Service /.�t� Amps Volts Overhead �d Und New Service ❑ No.of Meters / Amps / Volts Overhead 0 Undgrd Number of Feeders and Ampacity 0 No.of Meters Location and Nature of Proposed Electrical Work: Co .lesion o the ollowin_ table m. be waived. the Ins.- for o Wirer. No.of Recessed Luminaires G No.of Ceit.-S (Paddle)Fans o,of Total Transformers No.of Luminaire Outlets No.of Hot Tubs KVA Generators KVA No.of Luminaires Swimming pool Abodve ❑ In- ❑ o,o mergeacy . ,g No.of Receptacle Outlets I mod• Baste ' Units No.of Oil Burners No.of Switches � No.of Zones No.of Gas Burners 'o,of i erection and No.of Ranges ��S Initiatin_ Devices No.of Air Cond. No.of Waste Disposers Tons No.of Alerting Devices sP eat Pump umber Tons I= o.of el ontai, , Totals: Detection/Alertin• Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal 1 No,of Dryers Connection El Other rY Heating Appliances KW Security Systems:* No,of ater No.o No.of Devices or E.uivalent Heaters KW o.of Data Wiring: Si: s Ballasts No.of Devices or E.uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E.uivalent : Attach additional detail ifdesired or as required by the Inspector of Wires. Estimated Value of Electrical Work Work Start: (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VERAGE: 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 [73 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: Licensee: . ' LIC.NO' Signature 4,.....--e) LIC.NO.. O (If applicable, enter"exe/m��Dt"in the license lumber line.) Bus.Tel.No.: -�� L Address L9 ', vpittJln,e,lliC, - .. L., J `Per M.G.L. c. 147,s.57-61,security work requires Alt.Tel.No.: D - Ol License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that theLicens 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 0 owner's agent. 7 Owner/Agent Signature. Telephone No. i I PERMIT FEE: s