The URL can be used to link to this page

Home My WebLink AboutBLDE-20-001026 Commonwealth of Official Use Only trivior Permit No. BLDE-20-001026 Massachusetts 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:8/26/2019 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) 58 NAUTICAL LN Owner or Tenant =BIN CAROLYNNE 4100111111fti B l (,e5s Telephone No. Owner's Address 58 NAUTICAL LN,SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Chalk to lox) Purpose of Building Utility Authorization No Existing Service 100 Amps Volts Overhead 0 Undgrd ❑ ' 'eters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace exterior service equipment. 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 J No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting rnd. 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 ❑ 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 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 ❑ 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 6(2k9 C of �ctfs , Official Use Only otnnwntusa[th addac ii_A1+_ ' �� Permit No. • A 61-440 ail-- .2 E eparinul o/..cc77 irs Serviced f 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 EIectrical Code C),527 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: D.3 L ql City or Town of: YARMOUTH To the 1 ector o Wires: . By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Se /JtivyI4L .Owner or _it(Lp j,y,V,tlt /3 ;l Lss Telephone No. , -ago—aK1'/ Owner's Address ce /v/L't Li1'L Jpt_ S ✓rkzemo 411 I tr7/1 O' A 6641 Is this permit in conjunction with a building permit? Yes ❑ No - (Check Appro riate Box) Purpose of Building Utility Authorization No. it) D 'A35.--.SWy Existing Service Amps / Volts Overhead 0. Undgrd❑ No.of Meters New Service Amps I Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work:, -� /ne..,ie4— S -I- . "z¢._ Completion of the follawinz table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle Fans Tf Total) Trr anosformers KVA No.of Luminaire Outlets INo.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- ❑ o.of emergency Lighung irrnd srnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Tones No.of Switches INo.of Gas Burners No.of Detection and • .• Initiating Devices _ No.of Ranges No.of Air Cond. Tons TonsAlerting No.of Devices • No.of Waste Disposers Heat Pump Number Tons I KW 'No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local Q Municipal ❑ Other Connection No.of Dryers IHeating Appliances KW 4-Security Systems:* No.of Water KW Heaters o.of No.of No.of Devices or Equivalent - Heaters Ballasts Data Wiring: 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: 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 certify, under the pains and penalties of perjury,that the information on this application is true and complete.FIRM NAME: 2// E r%Lp.G�2-(G Lam. ,�-rJL)( LIC.NO.: Lt t G 14 Licensee: /27/(2.LL. ‘-i-tYiSE Signature LIC.NO.: c ''/i- (If applicable.gter"exempt"in the license nu b r line.) Bus.Tel.No.:575g-- 1 C/( w Address: /.O, fSoX t l9''t( c /Oh- a..146G'—//f of Mt.Tel.No.:S [-P14'-�7-.,-r j, *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. rle_� — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner El owner's agent. ` Owner/Agent 1 Signature Telephone No. PERMIT FEE: $