The URL can be used to link to this page

Home My WebLink AboutBLDE-19-003756 J d Commonwealth of Official Use Only etall Massachusetts Permit No. BLDE-19-003756 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.1/071 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:12/21/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm(hC fIn^o-rcat work des creClow. Location(Street&Number) 140 KATES PATH VILLAGE ,.� 1!x'(14 W L7/2-111 Owner or Tenant Telephone No. t Owner's Address 140 KATES PATH,YARMOUTH PORT, MA 02675-1452 Is this permit In conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd El No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace receptacles&switches. Upgrade circuit breakers. 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 ElIn- 1:1No.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 0 OTHER 0 (Specify:) /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 frrio`T C /�1V ,//'`�7 l.ommonama of/t/allachuSettt Official Use Only • , SIO =k cc�� c7 Permit No.- ( 37 r 1Japaritnad of Jiro Bernice! y -" _<<_ + Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. l/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: /2.-ao-18 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. 7' Locat on(Street&Number) /yo Ion-Es- ATV tz A ill f C}vn •or Tenant nEE FLA h e2 Telephone No. 617-y/3-6 946 1...., N OWtte•'s Address /go A rzs PATH YARil PMco /r 'st MA, 0244p Had permit in conjunction with a building permit? Yes 0 No E (Check Appropriate Sox) [1J cit PrP 3e of Building 9 es 1'4:Leig ldi'A L.... Utility Authorization No. C) w Estii g Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters — liJ[ Nev""See1rvice Amps / Volts Overhead 0 Undgrd 0 No.of Meters I t-� NumSSrr of Feeders and Ampacity /,usrrau. e¢ICG PAteir /Rit.aeO.''hd IIheu • cation and Nature of Proposed Electrical Work: Repiter SwN k.4.44,0) D m4.a,,ay et & t- a✓e Srn{,;lys �xvu 4-oA.�tt>E•4504)0,0U-0) Fceae etltt'afs as Lent, MRm. iS Completion ofthefollowinoitable may be waived by the Inspector of Wirer, No.of Recessed Luminaires No.of Cel.-Susp.(Paddle)Fans • Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool Above In- ❑ No.of Emergency righting ¢rnd. grnd. Battery Units No.of Receptacle Outlets No.of OB 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. Ton No.of AlertingDevices Tons • No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices A No.of Dishwashers Space/Area Heating ICW Local 0 Municipal other Connection No.of Dryers Heating Appliances KW Security Systems:* Ca No.of Water No.of No.of Data No. rDevices or Equivalent S Heaters KWSigns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - No.of Devices or Equivalent OTHER: O Attach additional detail if dertred or as required by the Inspector of Wires. Estimated Value of Electrical Worly (When required by municipal policy.) - Work to Start: /9...-2 1-IR 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 ® BOND 0 OTHER 0 (Specify.) I terrify,under the pains and penalties of perjury,that the information on this application Zr true and complete. ft FIRM NAME: CAI 5E flies re.Cr ( a. /Alf. LIC.NO.: In,,64A VLicensee: alma, a1Mg•Sc Signature ✓ I,,,.,2 Oita_ M.NO.: ni4cM (If applicable,enter"exempt"in the license number line) Bus.Tel.No.- 6'x8"39$-got I Address: P. D. An 1194 .c. braut"c (Y14. c7A4D-If4 If Alt.Tel.No.:5 -RVS-0078' J 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 rrna required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner ❑owner's agent t Owner/Agent Signature Telephone No. PERMIT FEE: S SD—