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Home My WebLink AboutBLDE-22-003111 Official Use Only Commonwealth of �:. i'' 0 Massachusetts Permit No. BLDE-22-003111 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) City or Town of: YARMOUTH DTo the Inspector of Wires: 1 By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 100 CAPT CHASE RD Owner or Tenant Gabriele DeGrace Owner's Address Telephone No. Is this permit in conjunction with a building permit? Purpose of Building Yea ElNo 0 (Check Appropriate Box) Utility Authorization No. Existing Service Amps New ng See p Volts Overhead 0 Undgrd 0 No.of Meters Amps Volts Overhead 0 Undgrd El No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wirin for sin le hi h DSC. 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 Transformers Total KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- grnd. ❑ grnd. ❑ No.of Emergency Lighting No.of Receptacle Outlets Battery Units No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges Initiating Devices No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Municipal Local 0 P 0 Other: No.of Dryers Connection Heating Appliances KW Security Systems:* No.of Water KV , No.of No.of Devices or Equivalent Heaters No.of Ballasts Data Wiring: Signs No.Hydromassage Bathtubs No.of Devices or Equivalent No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work to start: (When required by municipal policy.) 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 I certify,under the pains and penalties of perjury, ,er �,u that the information on on this application is true and complete. FIRM NAME: Christopher R Swift Pp P Licensee: Christopher R Swift (If applicable,enter"exempt"in the license number line.) Signature LIC.NO.: 37071 Address:8 PINE TER, E SANDWICH MA 025371432 M.Tel.No.: 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. Signature Telephone No. C PERMIT FEE:$75.00 ,1 // j. "'IL / a., p r anunonwea o �jfassac`/// husetts Official Use Only = J c� c7 Permit No. Z- r-2-2-'. 3 1 ( 1 y. 2 epartment el ire Services '' —`I e Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. I/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: i t D I 311 City or Town of: a,�"o(L� To the Inspector of Wires: By this application the undersign yes notice o is or her intention to perform the electrical work described below. Location(Street&Number) / 01, Chat/ i t ti &�� Owner or Tenant Gann .1? —DDe ` .i cc VV "S';I�,, Telephone No. Owner's Address 1( J •t 19 ,(\ C ,' (-� P * ! �p Is this permit in conjunction with a building permit? Yes 0 No 'C �/ (Check Appropriate Box) Purpose of Building '�Oe..,1( Utility Authorization No. Existing Service /OC Amps )tC /a 0 Volts Overhead I —I Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead n Undgrd g 4r111 — 0.of Meters Number of Feeders and Ampacity / tt0e1107" Location and Nature of Proposed Electrical Work: W 1 re (K_ S 1 d Jo T`$ C. Completion of the followinktable 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 INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I.KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal No.of Dryers HeatingAppliances KW Security Systems:* Connecton ❑ Oth� PP No.of Water KW No.of No.of No.of Devices or Equivalent Data Wiring: Heaters Signs Ballasts No.Hydromassage BathtubsNo.of Devices or Equivalent No.ofMotors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent (� Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value o Electrical Work (When required by municipal policy.) Work to Start: it I Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: 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 coy age is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE al BOND ❑ OTHER I certify,under the pain d^penaflie er ❑ (Specify:) FIRM NAME: t N l ` ,fp ` :that the information on this application is true and complete. Licensee: LIC.NO.: (Ifapplicable,enter "exempt"in the license number line.) Signature LIC.NO.: Address: Bus.Tel.No.: "_ -(8 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: AIt.L et�NNo o.. 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/Agent y Signature ❑owner's a_ent. Telephone No. PERMIT FEE:$