BLDE-23-003961 ram / Commonwealth of Official Use Only
(0 Massachusetts Permit No. BLDE-23-003961
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:1/20/2023
City or Town of: YARMOUTH 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) 36 BELLE OF THE WEST RD
Owner or Tenant JOHN DENNEHY Telephone No.
Owner's Address
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&bathroom.Wire new bathroom.
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
grad. 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
Initiatine 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 0 Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Signs 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: NEIL SCHOENER
Licensee: Neil Schoener Signature LIC.NO.: 13949
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:44 TRADERS LN,W YARMOUTH MA 026733333 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 my
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
/�4 6-1V01 mil) t/'/z3
i'[/ (/ )/ts t
Commonwealth o/Maddachiudattd Official Use Only
It~ .B ft ��7 Permit No. Li —-'1 (
�--01.. 11 .partmenE° nc�irs Jerviced
' ",'I f �+ Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS (Rev. (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 ?e ? 3
s City or Town of: YARMOUTH 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) 3 C., e, e 1 i e' F iA., , tsr (Z cQ ya;,,,e.A14 /c,-
Owner or Tenant J Inn y Telephone No.
Owner's Address
Is this permit in conjunction with a b Ming permit? Yes No ❑ (Check Appropriate Box)
Purpose of Building 1 TC Len 6 ?N roh,, d
Utility A thorization No.
--- Existing Service G) Amps / / 2l�Volts Overhead[KUnd Undgrd
g ❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
Number of Feeders and Ampacity
C Location and Nature of Proposed Electrical Work: I/2.i it
oL W t0— net e A- Dc-cC b1n+.2be an
`" J 11 Completion of the followingtable m be waived by the Insps�ector of Wires.
1t No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans
No.off Total
(Ni Transformers KVA
t'`��,1) No.of Luminaire Outlets No.of Hot Tubs Generators KVA
<t;' 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
c. — . Initiating Devices
11! No.of Ranges No.of Air Cond. Tons) No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: ,Detectionalerting Devices
Space/Area HeatingKW Municipal
No.of Dishwashers S
p Local❑ Connection ❑ Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of Devices or Equivalent
' Heaters KW No.of No.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:
f7 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: I - .`l 2. -3 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 cov�e a is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE [f 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: t L S G k c t-,z /� o
LIC.NO.: A 13 l`-( cr
Licensee: Signature LIC.NO.:
(If applicable,enter/'qrf spt"i the license qumter lire.) Bus.Tel.No.: T t`r
Address: `�1 "I TC4 D e(S �" w �{GQ.2 on c vj7f 4 0 3 Alt.Tel.No.: J e'� 1 I S 7
*Per M.G.L.c. 147,s.57-61,security work requires Departmentlof Public Safety"S"License: Lie.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)❑owner ❑owner's agent.
Owner/Agent I
Signature Telephone No. I PERMIT FEE:$