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Home My WebLink AboutBLDE-22-001130 �- Commonwealth of Official Use Only Lilie5;:,. Massachusetts Permit No. BLDE-22-001130 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:8/30/2021 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) 105 CONSTANCE AVE Owner or Tenant ROBBINS DEBORAH Teleph Owner's Address DEBORAH A POOLE, 105 CONSTANCE AVE,WEST YARMOUTH, MA 02673 one No. ts Is this permit in conjunction with a building permit? Yes 0 No CI (C Box ' Purpose of Building Existing Service 100 Amps Volts Utility Authorization No -0 Overhead 0 Undgrd 0 , rs 6 6 New Service 100 Amps Volts Overhead 0 Number of Feeders and Ampacity Undgrd 0 No.of Meters Location and Nature of Proposed Electrical Work: Upgrade exterior service equipment only. 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 No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Aboved. g❑ Inrid. ❑ No.of Emergency Lighting grn Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.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 0 Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts Siens Data Wiring: No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 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 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 fperjury, J �, ,under the pains and penalties o er u that the information on this application is true and complete. FIRM NAME: MICHAEL J CHASE Licensee: Michael J Chase Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 20654 Address: 19 MAYFAIR RD,SOUTH DENNIS MA 026602903 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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)) ❑ owner ❑ owner's agent.Owner/Agent Signature Telephone No. Z 'PERMIT FEE:$50.00 I - —A C,omnwnwealk o//rladsachudeltd Official Use Only irl Town of ermit No. c j -v1111— 1 2ePartmen`o gins eivcea — Elec Inspector:Heal 2 = BOARD OF FIRE PREVENTION REGULATIONS 508.430.7507 Ext. Occupancy and Fee Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code_ C),527 C 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: D a 6 ) 6 - City or Town of. Vourq To the Ins ector of ires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) I D 5- GOa0.5 -4-PG2..- Auc_ Owner or Tenant �b i C-- Poo Co— Telephone No.5z -1 gq 3,`(o Owner's Address (o, a>a)ST Ce— - _ (A). L4447.4.frio,f7-i J ,r 6aC.73 Is this permit in conjunction with a building permit? Yes ❑ No I (Check Appropriate Box) Purpose of Building (2e -tUK— Utility Authorization No. &sO r I d Y Existing Service PO Amps /al0/d-C) Volts Overhead a Undgrd❑ No.of Meters I New Service I to 6 Amps ° ` / Volts Overhead®- Undgrd ❑ No.of Meters I Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ��( 0 IJ too 14 �‹efL4J Out 17�2--ONl t✓ Completion of the followin&table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans NoTr 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 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. Tons No.of AlertingDevices 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 Monnectiounicipaln 0 Other C No.of Dryers Heating Appliances KW Security Sistems:* No.of Devices or Equivalent _ No.of Water KW No.of No.of Data Wiring: 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 desire4 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 Cif, 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:j6 H E- E LE n2-,L Z, LIC.NO.: ILL ( Licensee: /YI((-,l y¢ (, Ca'ASO Signature G LIC.NO.: d.G t..5-11A (Ifapplicable, rater "exempt"in the license number line. Bus.TeL No.:.. 3T8-Zoj Address: O. C3C2x I t I ci S`. � 3 Arif G)..6 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lie.No. b 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. I PERMIT FEE: $ I