Blde-19-005786 Commonwealth of Official Use Only
111,1% Massachusetts Permit No. BLDE-19-005786
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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:4/16/2019
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 el work descn w.
Location(Street&Number) 30 CHANNEL POINT DR C-0ri Owner or Tenant SOLOMONS ANTONY H Tea lone No.
Owner's Address 52 WALNUT RD,WESTON, MA 02493
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: Exercise room&art studio.
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 12 No.of Ceil:Susp.(Paddle)Fans 2 No.of Totay
Transformers KVA
No.of Luminaire Outlets 13 No.of Hot Tubs Generators K'A
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units ,
No.of Receptacle Outlets 12 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 6 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 1 Local 0 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: 1
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: ADAM G LEPIRE
Licensee: Adam G Lepire Signature LIC.NO.: 21742
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:8 PICASSO PL, OSTERVILLE MA 026551245 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: $75.00
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�i__ .1 Department o Permit No. 7 8 6
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BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
(leave blank
•
APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:
— City or Town of: yARMOUTH To the Inspector of Wires:
By ins application the undersigned gives notice of his or her intention to perform the electrical work described below.
,; .�:_.,_. t,oration (Street&Number) `'" fict7 '/r
.. ,,,, Ow!$ter'orTenant � C-e�+ _tex._ Telephone No.
ow er s Address
IPifieltijA/6
�- ti permit in conjunction with a building permit? Yes ❑v No ❑ (Check Appropriate Box)
0 ` nose of Building
IliUtility Authorization No,
.. .....jExisting Service Amps / Volts Overhead ❑ Undgrd❑ No,of Meters
__._____.•_ar:_._.._,Ne Service Amps / Volts Overhead❑ Und d
gr ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: , I gK4J 5 V�
4 4<� . 9cz ,4 �l�� l�
Completion of the following table may be waived by the Inspector o Wirer.
No.of Recessed Luminaires f L, No.of CeiL-Susp.(Paddle)Fans No.of Total
Transformers ICVA
No.of Luminaire Outlets /, No.of Hot Tubs Generators KVA
• No.of Luminaires / Swimmia Pool Above In- No.of Emergency Lighting -
garnd. ❑ ern& ❑ Battery Units
No.of Receptacle Outlets /2_ No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 4 No.of Gas Burners No.of Detection and
Initiating Devices
Total
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:I , Detection/Alerting,Devices
No.of Dishwashers Space/Area Heating KW / Loral❑ Municipal 1-7Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
y No.of Water of No.of Devices or Equivalent
its Heaters KW SignsNo, No.
Data Wiring:
No.of Devices or E t_g alert Z_____
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 Wirer.
Estimated Value of El ctric Work
(When required by municipal policy.)
Work to Start: j. Inspections to be requested in accordance with MEC Rule l0,andectr uponw completion.
unlINSURANCE C RA E, Unless waived by the owner,nou permit for the performance of electrical
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. Thess
undersigned certifies that such cover a is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:)
I certify, under the pains and penalties ofp 'ury,that the info ation on this application is true and complete.
FIRM NAME: I�./✓
Licensee: LIC.NO.:
_./YAPt
Signature LIC.NO.: ?
Add
(fapresplicar.ble,g3er m t.to tl5O ense�rrrtber 'tie.) fig
U v�� Qi�1�7S� us.Tel.No..
•
J "`Per M.G.L. 57-61,security work requires Department of Public Safe Att.Tel.No.: j/l'�;�d 07�
Lic.No.
OWNERby law.'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n— o /C7
OwnredAgent By my signature below,I hereby waive this requirement I am the(check one 0 owner ❑o
Signature wner's a ent
al
Telephone No. PERMIT FEE: $ 7
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JAN l'0 2019
L;FLOOD VENT FLOOD VENT
LEGEND: HEALTH
f—I EXISTING WALLS
CONSTRUCTION TO BE REMOVED THE PROPOSED WORK IS VALUED LESS THAN 50%
ram NEW CONSTRUCTION OF THE EXISTING HOUSE VALUE AND IS A SOUTH ELEVATION
LATERAL ADDITION
'�® L:°�"P.>.'"u•ab.I:"`•o' SCALE: HDRAWING NO.
COTUIT BAY DESIGN, LLC NEW REMODELING/ADDITION FOR: t R•E M ,/41._,N-UH
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43 BREWSTER ROAD g1onA ^••EP^ •PCO"^TM�'
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• MASHPEE,MA. 02649 COOPER RESIDENCE �,,,,N T..., . H°
I'. PH.(508 274-1166 1 \ 119. 0 NO. DATE
FAX 30 CHANNEL POINT DRIVE W. YARMOUTH, MA 'A11�i-.�,cu�it,� `,,"" 12/20/2018
• PI ZIl I°57,0,,1',UNLIT
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