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BLDE-21-007313 o• kr/ Commonwealth of Official Use Only ti` Massachusetts Permit No. BLDE-21-007313 K • 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:6/16/2021 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. f Location(Street&Number) 160 SOUTH ST 3 _c*1(} t- 8 z3z'C Owner or Tenant FRANCHI DANIEL J TRS Telephone No. Owner's Address LEWIS ROY TRS, 35 TODD ST UNIT#212, HAMDEN, CT 06518 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: &receptacles for A/C's. 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 3 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. 1 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine 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 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 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 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 6)1,4S1 fE 13J&- / AComsso*woo&ol Mate Official Use Only c�� t 73 f : '. o�,}ins � Permit No. t' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK `5 All work to be performed in accordance with the Massachusetts Electrical Code( , 27 CMR 12.00 Q): (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /`�/-�- City or Town of: To the I pector of Wires: By this application the undersigned gives notice�� his or her intention to perfonn tie electrical work described below. V Location(Street&Number) (y O Sd f7"e_, Owner or Tenant C l+ Telephone i g,w ' [ Owner's Address / 0 © 74* 'f� t— _ Atz,vievtil t MA- o k C Is this permit in conjunction with a building permit? Yes [❑ No (Check Appropriate Box) Purpose of Building � {r/C. Utility Authorization N . Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters SI Number of Feeders and Ampadty ® ,, Q L�and Nature of Proposed Electrical Work: �-t-J S7-lg (/ &LAX' i� 3 <t/L _ e 9-e/c.,,5 d - Gv )-6 A- cPi+i Ce esr Completion of the followinK table my be waived the In ctor of Wires. Lb No.of Recessed Luminaires No.of CdL-Sa:p.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Poo, Above In- Pio.of a mergency Lighting grad. arnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners `!Qa of Detention and Initiating Devices 11' No.of Ranges No.of Air Cond. Ton' No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons _ KW 'No.of Self-Contained Totals: . __.._ Detection/Ale , , Devices No.of Dishwashers Space/Area Heating KW Local 0 Mun t onnentlen ' No.of Dryers Heating Appliances KWSecurity stems.:* No.of Water No.of Devices or Equivalent Heaters , No.of No.of Data Wing: Signs Ballasts No.of Devices orEquivalent No.Hydromassssge Bathtubs No.of Motors Total HP Telecommunications of Devices or Equiv .nt OTHER: Attach additional detail ifdesirea 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 -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:( f SE G G'®'.. ,U c..‘ LIC.NO.: I`l SO AI Licensee: f rif c,;�/ _ e E Signature LIC.NO.: 't'ls-{'f/A (If applicable enter"ex in the license ber line. Bus.Tel.No.cC� - -Rel I Address: V`0. nx i f _min 1-5 ,/Flit- d)4Cc-LC 1 a *Per M.G.L.c. 147,s.57-61,security work requires A TeL No.t3?Si� 3R�[d Department t�f 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 Q owner's agent. Owner/Agent Signature Telephone No. 1 PERMIT FEE:$