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Home My WebLink AboutBLDE-22-002523 Commonwealth of Official Use Only en Massachusetts Permit No. BLDE-22-002523 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:11/3/2021 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) 7 KIT CARSON WAY Owner or Tenant ROBIDA YVETTE C Telephone No. Owner's Address 7 KIT CARSON WAY, 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 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement of exterior service due to storm. 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 ❑ 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 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW 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 Ballasts Data Wiring: Heaters 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: 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: MICHAEL J CHASE Licensee: Michael J Chase Signature LIC.NO.: 20654 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 19 MAYFAIR RD, SOUTH DENNIS MA 026602903 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 my 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 C..ommonwealUe o j//lamach.u.5efte Official Use Only fr _ . �2Z- 7-3 cry�� cc7 Permit No. -� ST 2apartment o`.}ire Sen./ice-4 2 i Occupancy and Fee Checked ' w BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) '`i ` APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 1 All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CM 12.00 S (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /e I-a. ?-( City or Town of: YM-ivl& 7--t To the Inspector of Tres: 1 By this application the undersigned gives notice of his or her intention to perform the electrical work described below. J Location(Street&Number) 7 I'‹I 1 CAi S'errs 6)/ '( % _ Owner or Tenant Y1/e-ire- !Z �j I 6 rb /4 Telephone No., -7. ), —`761J Owner's Address 7 t(.1l GAR.SocJ (,vt7 V n o--T�( �'4 i ( ) 7 C— CI ' Is this permit in conjunction with a building permit. Yes C No L (Check Appropriate Box) Purpose of Building i --r- Utility Authorization No. Existing Service Amps / Volts Overhead n Undgrd No.of Meters New Service Amps / Volts Overhead n Undgrd ❑ No.of Meters d Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: gwrE46- Zvi e. l'e-Pl rt�..^"—'1 l cv X. ec VICompletion of the followingtable may be waived by the Inspector of Wires. Lb No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers No.of Total KVA G1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA a k No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units 'zi No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches In No.of Gas Burners No. Deteon and Initiating Devices No.of Ranges No.of Air Cond. Total g Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained P� Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other Cyyonnection No.of Dryers Heating Appliances KW *Secs:* urity Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Eouivallent , No. Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNo.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 21 BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: --/-, ( FL�-G!2 C - -l- C . LIC.NO.: PI'c 4 Licensee: /2-7f -'-f/i-.,) /4 . Signature /�?�`i' //a.-`- LIC.NO.: 7, 2t A (If applicable,enter"exempt"in the license number lin Bus.Tel.No "3�i - a''/ Address: (? (1 , k 1) el �H C M/1- G)-Cl�c;- Il"t 7 Alt.Tel.No.:s�k-aY.1= e'1O *Per M.G.L.c. 147,s. 57-61,security work requires Departmet{t 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 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. PERMIT FEE: $ 'lour — - ,- _