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Home My WebLink AboutBlde-20-001641 • ;:/ J ' Official Use Only -.:'! • Commonwealth of !° Massachusetts Permit No. BLDE-20-001641 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:9/24/2019 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 electrical work described below. Location(Street&Number) 321 LONG POND DR Owner or Tenant MAY MARGARET A Telephone No. Owner's Address 321 LONG POND DRIVE, SOUTH YARMOUTH, MA 02664 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: Install generator&smoke detectors. 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 1 KVA 11 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 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 1 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 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 ❑ (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. 1 PERMIT FEE: $50.00 PV/f /-z$ 69 e CC ZIV s��,1C6 EA- 40LT)/ : Commonwealth of///addac�tt ,. Official Use Only _: 1 4 1 '== c� Permit No. ?� --s!!= ..Usparfineni o/.girt;Serviced =tf_ " ' 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 Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFO TION) Date: q / ci l er City or Town of: `l/�(I.(i�.�t,� To the Inspector o ire By this application the undersigned gives notice of his or her i tention to perform the electrical work described below. Location(Street&Number) 3 k( (44.,6 6 soU-L- Owner.or Tenant rk 6 A, - MAI- Telephone No. 34g 7/011 Owner's Address 3a c Lor-5- ?OA- ,k stj S- -i!/1i.s-4" ,t uq._ pa_cao( Is this permit in conjunction witha building permit? Yes ❑ No g (Check Appropriate Box) Purpose of Building /C e s c c1-erkii-c`:4(_ Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ 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: fit,( (1 k_- S- y /019-ALL Sit o(Ce j-, Completion of the followin&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 grnd.. mar nd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches 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 Local Municipal Q Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Heaters KW 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: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electri al Work: (When required by municipal policy.) Work to Start: 7/2 41 / 1 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 g-BOND 0 OTHER ❑ (Specify:) I certify, under theiai7 and penalties of perjury,that the information on this application is true and complete. /� FIRM NAME: C �,E e9. .lie_ LIC.NO.: Strr6Y04" Licensee: th, 2.GX_ 1 E Signature ''"j Gr✓--------- LIC.NO.:f1S f= (If applicable.enter"exem t' in the license number line.) Bus.Tel.No.: 5V. g0`( Address: P-0- Se— I.(Tc( S-Zl` / ` 74.1-- O-'1-('O—l{r Alt.Tel.No.98 f " 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 n�— required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ 1 1