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Home My WebLink AboutBLDE-22-000716 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-000716 ft.--' 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:8/9/2021 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) 10 LILAC LN Owner or Tenant MAXWELL RICHARD B Telephone No. Owner's Address MAXWELL LEILA R, 10 LILAC LN,YARMOUTH PORT, MA 02675-1559 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 recessed lights Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 6 No.of Ceil.-Susp.(Paddle)Fans No.of .. </j Tal Transformers O �+ VotA No.of Luminaire Outlets No.of Hot Tubs Generators ,, KVA No.of Luminaires Swimming Pool Ag ❑ ,';d. ❑ No.of E i Battery Un 4° — No.of Receptacle Outlets No.of Oil Burners FIRE ALA ..d •on No.of Switches No.of Gas Burners No.of Detection and 8Ath z9Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ton f' 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 0 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 0 (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 CoMMonrvsatg of mase Official Use Only ,' _ •, cc�� Permit No. ZZ -107( 2)spar insai el c7 ire—cervical ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M C),527 CMR 12.00 ' (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: g "V -.0 a 1 -s City or Town of: yI'kZ vrld 017-f To the Ins ctWires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) I CL I L A c_... L IA)- Owner or Tenant Li Lek- + 21 GK_ MAxst j( Telephone No.5Z' -a f j-O ). Owner's Address /0 L. i LhG 6410-e— Is '// , 4'(fp 07_, /''rel Da(0 7 Is this permit in conjunction with a building permit? Yes 0 No a (Check Appropriate Box) Purpose of Building // S i — Utility Authorization No. ---4 Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd El No.of Meters Number of Feeders and Ampadty v1 Location and Nature of Proposed Electrical Work: Att S0.2) S S S Li c4-*c II) ( e.0K ®Q (1) aeocess Com- tri r- 0-1 C..i --,end.-,., rCompletion of thefallowingtable stay be waived by the In eefor of Wires. No.of Recessed Luminaires No.of Ce11.-Sump.(Paddle)Fans No.of Transformers KVA KVA Gt No.of Luminaire Outlets No.of Hot Tubs Generators KVA a - No.of Luminaires Swimming Pool Above ❑ In- ❑ BatNo.er units Lighting cond. grnd. Battery Unita `l No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones : No.of Detection and No.of Switches No.of Gas Burners Initlatina Devices 61' No.of Ranges No.of Air Cond. TOS No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: _. I _._._.__.. DetectionlAler Devices No.of Dishwashers Space/Area Heating KW ,Local❑ M 0 Other Connection No.of Dryers Heating Appliances KWy Ss,:*. No.of Devices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or ��qq uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telce°mm Devices r E1�V2r a Na of Devices or Fq t 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 Es-- 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: C�/,E EZEG772.1c GO. :730<--. LIC.NO.: I L(W14I Licensee:'79 ' 4EL alii( Signature— /�'' 6,ie- - LIC.NO.: 266 s`(A (If applicable,figr.,exempt"in the license numbee 1' ) Bus.Tel.No.:$1.-5 IQ/Address: IPPRf30x. 11.'t K S. ei' 1S f'W4 -6 Cc— (1't Alt.Tel.No.: )-`j f=.3' o *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$