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Home My WebLink AboutUntitled 4ACommonwealth of Official Use Only L. "� �. l,6 rr Massachusetts Permit No. BLDE-21-004775 B `ARD 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:2/23/2021 City or Town of: YARMOUTH To the Inspector of Wires: f� rI�� // ll By this application the undersigned gives notice of his or her intention to perform the electrical work described below. C:t L) 2-( Location(Street&Number) 300 BUCK ISLAND RD UNIT 21 U 11/4}it DJ - 8 Owner or Tenant MUNDHENK CHARLES F(LIFE EST) Telephone No. Owner's Address MUNDHENK KATHLEEN M (LIFE EST), 15 FISHER RD, HINGHAM, MA 02043 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 6 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 1 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool grndAbov.e ❑ In-grnd. o No.of Emergency Lighting _ Battery Units No.of Receptacle Outlets 6 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 1 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 1 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. 7 ..1 _� CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) C/ f5 3 6g4 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Conor James Delorme Signature LIC.NO.: 56756 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 18 Pondlet Place,FAlmouth MA 02540 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. P 'MIT FEE: $75.00 IA R O�c //QQ (3Q) t f 771- (N s r0 1 t 36- ve s�ranL Inrl (9f2 ( t ...,, 5-42? i 6_ 02.7._/, Y &k Conuwnwiraaa o{Yilassacisausiis Official Use Only \:01- ' �U.par�iw.rrE of.trns Permit No. �`k 75. 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 Ivisissadrinetts Electrical Codea s� R 1 .00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: �f ' -- City or Town of: W f 5-1- ``o•f(v v' -YI 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) 300 ewck tS IA vtd Pct VA ti- I E Hoa 1 C IGI n Lan Ac) Owner or Tenant ri hal r(ir. M V Nj IleI Telephone No. Owner's Address 300 13io'ck T5 Ic,Ad- V A Una+ I G— Is this permit is conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building 1►1/'o'111 I d eAc e f/2\n 1`c) Utility Authorization No. Existing Service Amps jU / 6(ili Volts Overhead❑ Undgrdtr No.of Meters l a New Service Amps / Vols Overhead 0 Undgrd❑ No.of Meters N Number of Feeders and Amity Location and Nature of Proposed Electrical Work: is;}c h e n (e 1m a 6 P 1 e, Completion of the foilowinktabk mcy be waived by the fetor of Wires. ll) No.of Recessed Luminaires 6 No.of Celt.-Snap.(Paddle)Fans No.of Teta) Transformer KVA KN. No.of Luminaire Outlets 0 No.of Hot Tabs Generators KVA A.. No.ofLuminaires I swimming pool Above ❑ In- , ❑ No.or Eumenzency L tgliting �l No.of Receptacle Outlets Fj No.of Oil Burners FIRE ALARMS No.of Zones Detection and t Na of Switches / No.of Gas Burners Na oft nitiating Devices 1�.' No.of Ranges ! No.of Air Cond. TotaloNo.of Alerting Devices Na of Waste Disposers a Heat Pump Number Tons KW___ Na.of Self-Contained Totab: Detectioa/ADeviees No.of Dishwashers 1 SpacelArea Heating KW Leal❑ Mia 0 Other No.of Dryers 0 Heating Appliances KWSecurity ." No.of�s or Equivalent No.of Water KW No.of No.of Data Heaters Signs Ballasts No.of Devices or - , t _ No.Hydromassage Bathtubs No.of Motors Total HP T ecommunicadons No.of Devices or Fal OTHER Attach additional detail ifalesired or as required by the hrspector of Wires. Estimated Value of Electrical Work o1fJf// (When required ired by municipal policy.) Work to Start: W8,q f kin' 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 covigage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE D. BOND 0 OTHER 0 (Specify:) I mite,ander the pains and penalties ofperjary,that the inforaroalon on this application is true and cos FIRM NAME: i 5 ea n5VroWe Gca/►-pr►y Zr eLIc.No.: UI)G4 �I34 5 — Licensee: :,.1/11144.J I0. LL Stere (� LIC.NO.: S 7 . 6L- (lfapplicable."'' "exempt"in the license number line.) Bus.Tel.No.• a( Address: Alt.Tel.No.: *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 required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agent. Owner/Agent /^/l Signature Telephone No. PERMIT FEE:$ 7 5 a/