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Home My WebLink AboutBLDE-21-003608 a . Commonwealth of Official Use Only Permit No. BLDE-21-003608 EE 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:12/31/2020 City or Town of: YARMOUTH To the Inspector of Wires: Q By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 390 ROUTE 6A Q Owner or Tenant WOOD MARY LOU TRS Telephon O 1 Owner's Address WOOD FAMILY RLTY TRUST, 390 ROUTE 6A,YARMOUTH PORT, MA 02675 �� Is this permit in conjunction with a building permit? Yes 0 No 0 (Check App • O Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Met• Q New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity a Location and Nature of Proposed Electrical Work: Wiring for porch. 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- 0 No.of Emergency Lightin grnd. grnd. Battery Units <, No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS N .of Z nes L�\ No.of Switches No.of Gas Burners No.of Detection a i' InitiatineDevic �+ �� No.of Ranges No.of Air Cond. TotTons No.of Alerting Devices-, _,� No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained • c1�o Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ":;Q ` pthe� ,/ Connection No.of Dryers Heating Appliances KW Security Systems:* � � No.of Devices or Equivalent , No.of Water KW No.of No.of Data Wiring: t ,d , / 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 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:$75.00 R&1L i lc/2/ a (Afetz eu t l.-1'4a17tl015 Sg?9-1Q0 14 Commonumat'tta el Maooac%we4 to �Offffficial Use Only p, •' •J c� Permit No. `—3 6 0 t d - 2sparimanf 4.7i,..&rated Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) s' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 3 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: Ial3 /a-6)_e City or Town of: /4R{^'001X To the Inspect° of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. 0 Location(Street&Number) 3RD p-nti0 S 4 -iii 6/ .0 0,-,7-- j Owner or Tenant cfr7 `( La u Telephone No.Pg-737 (Q)-g' Owner's Address 310 r'i R t S flZ /LTE' to Bl- yfrrzes.v ot€fon-;j /if �Ig o- -67s' J Is this permit in conjunction with a building permit? Yes No No ❑ (Check Appropriate Box) - Purpose of Building f i t- Utility Authorization No. ti) Q) Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters -S Number of Feeders and Ampadty 1 Location and Nature of Proposed Electrical Work: c,t);, Nc, Q G�(6 /2 e..., L,: Y .f PfdLf- v) Completion of thefollowingtable may be waived by the Inspector of Wires. lb No.of Recessed Luminaires No.of Cil.-Susp.(Paddle)Fans Na.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of LuminairesSig Pool Above ❑ In- ❑ No.of Emergency Lighting fund. arid. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones and T No.of Switches No.of Gas Burners No.If �ec�on m tal 1 VI No.of Ranges No.of Air Cond. To No.of Alerting Devices No.of Waste re Heatns Pump Number Tons _ KW allo.of Self-Contained Totals: Detection/AlediDgpevices No.of Dishwashers Space/Area Heating KW Local 0 Conation 0 Other No.of Dryers Heating Appliances KW Security o. f stems:Devim or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or . ,uivalent No.Hydromassage Bathtubs No.of Motors Total HP T Na of Devices or Eq, ,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 hi 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 a BOND 0 OTHER 0 (Specify:) I certify,under the pains and penaldes ofperjury,that the information on this application is true and comple FIRM NAME: CHASE €i. �� Ca . ,PG. LIC.NO.: C64 40 Licensee: fYlA(ti^- C.1,11D'E Signature 270..." 1-6/-,----- LIC.NO.:g44't¢ (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:( °'T1t 1 G 1/ Address: Pa- 3a7,-- 1 1'1 L 5- ,..1)e,14 2, "'I4?-1: 0-111‘f Alt.Tel.No.: Com` dam7K r- *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)0 owner 0 owner's agent. Owner/Agent/ Signature Telephone No. PERMIT FEE:$