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Home My WebLink AboutBLDE-19-003113 a le Commonwealth of OtrcialUse Only rE' !1i Massachusetts Permit No. BLDE-19-003113 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.l/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 (PLEA SE PRINT IN INK OR TYPE ALL INFORMATION) Date:11/20/2018 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) 15 WILLIE BRAY RD Owner or Tenant RICHTER SETH G Telephone No. Owner's Address RICHTER KATHERINE L. 15 WILLIE BRAY RD,YARMOUTH PORT, MA 02675 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for screened 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 2 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ElIn- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 3 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 0 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 Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent A 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. CIIECK 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: Mark H Chase Licensee: Mark H Chase Signature LIC.NO.: 8669 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:21 DRAKE ST,YARMOUTH PORT MA 026752204 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:$50.00 qA— ctf& (te 1 rr f it gt 6e) kverst 00spe ) JJtctComet= / •a. ,.sammo. of�/a eaahd f r ,OfEcial Use Only =iyPermit No, 2-3c ( 3Tt *oarimsnf of Thee gervicn # ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07] . (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),52jj7 CMR 12.00 (PLEASE PRINT IN INK ORTYPFALL INFORMATIOA9 Date: il/Iq / g City or Town of: YAILMOUTFI To the Inspector 4Wires: • . By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) i1/45- W i 1iic_ a ply 2.0/1-1 OwnerorTenant ��( -& ( -� RI u(Te.-C—. Telephone No. 16 Owner's Address jr /Wit"— t5 1461t_ Is this permit in conjunction with a building permit? Yes Na .... ,❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 Ni.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: W,ytt_. ('A-J(��f4'°/a, 6-13)-1-e- (Anti i;b • e_$' O a.,-e_ 3 wy, c K D•' ,�' _sec? /moa-vcou/far.. Completion of thefollowin_ table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeilrSusp.(Paddle)Fans No.of Total Transformers KVA Aio.of Luminaire Outlets No.of Hot Tubs Generators KVA 0 Llo.1 of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Elguang Knit. grnd. Battery Units C ; c o. rf Receptacle Outlets No.of Oil Burners FIRE ALARMS JNo.of Zones ' ' $o.,)f Switches o.of Detection and fs it—hb No.of Gas Burners , 'al Initiating Devices Ico•i f Ranges No.of Air Cond. Total on l No.of Alerting Devices V 0 (Waste Disposers Heat Pump Number(Tons KW No,of Self-Contained t(J • P Totals:I——_J Detection/AlertinKDcvices _ IYo cfDishwashers Munici al i Space/Area Heating [CW' Local❑Connection 0 er No.of Dryers Heating Appliances KW Security Systems:" No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Si•ns Ballasts No.of Devices or E,uivalent No.Hydromassage Bathtubs No.of Motors Total HP I7'elecommunications inng: No.of Devices or Equivalent OTHER: Attach additional detail f desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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. CHECK ONE: INSURANCE a BOND 0 OTHER ❑ (Specify:) I certify, under the,pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: tIE EC-ea-act Ca - A- LIC.NO. _ Licensee: �Aer"x �/n�� slgnaturF��l2�_ LfC.NO.: (ljapplicabl iter"exempt"in the license rytubqr fine.) Bus.Tel.No.. 3 Address:, �6k (/qG( H /14- a6� J 'Per M.G.L.c. 147,s.57-61,securitywork D // `a I Alt.Tel.No.:<Th-}4S= le requires ep'artment of Public Safety"S"License: Lic.No. Q OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally t OwnrrdlA by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. i Signature Telephone No. ( PERMIT FEE: $ SO 1