BLDE-21-005165 /./A, Official Use Only
or g;►�s' Commonwealth of
r ` Massachusetts Permit No. BLDE-21-005165
i BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.I/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•3/11/2021
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) 27 SPRUCE ST
Owner or Tenant Bryan Cotten Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters
New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Wire for new bedroom, master bathroom, rewire existing bathroom&kitchen,
split A/C,&relocate service.
Completion of the following table may be waived by the Inspector of Wires.
No.of Total
No.of Recessed Luminaires 12 No.of Ceil:Susp.(Paddle)Fans Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ I rnd. El No.
of Emergency Lighting
grnd. g
No.of Receptacle Outlets 21 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 22 No.of Gas Burners No.of Detection andInitiating Devices
No.of Ranges 1 No.of Air Cond. 1 Tons No.of Alerting Devices
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Alerting Devices
al Munici
No.of Dishwashers 1 Space/Area Heating KW Local 0 Connection 0
Other:
1 HeatingAppliances KW Security Systems:*
No.of Dryers pp No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters
KW Signs Ballasts No.of Devices or Equivalent
Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
required Value of Electrical Work: (When q uired by municipal policy.)
y'
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:) P1 3, in1
I certify,under the pains and penalties of perjury,that the information on this application is true and complete. -3f3 to
FIRM NAME: Edward Chaves LIC.NO.: 35806
Licensee: Edward Chaves Signature
applicable,I enter"exempt"in the license number line.) Bus.Tel.No.:
Address:55 SUZANNE DR, RAYNHAM MA 027675166 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.B
signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. rr""r'"
/
Owner/Agent -�'
Signature Telephone No. 'PERMIT F4: $75.00 _ I
'f c.ao P!
41 r1(C/4 K6
14 Commonweal el Maeeaclwatto /�Official Use Only
,` i� eri c7� c7 Permit No. 1.:' 51 CO
L - ..dapartmsnt of Jinx�srvicSS
V, K- !i" J 4 Occupancy and Fee Checked
'.. ,� BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
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: 3 - g -c2 I
City or Town of: YA2 A400111 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) Sj RI, cs(l'"Af T'
Owner or Tenant J3 yQ y/d iki oVre pl, Telephone No. ?7y Y Y-Zfj
Owner's Address c hdaE
•1-% Is this permit in conjunction{� with a building permit? Yes M No ❑ (Check Appropriate Box)OLD -21-Bo37A
—� Purpose of Building 5 E. /.16/1 .(, Utility Authorization No.
Existing Service /DC) Amps ja )I 2v Volts Overhead a Undgrd❑ No.of Meters I
i New Service )p p Amps Aar) /PV Volts Overhead® Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Li),,A C fog 1'2- 4DI)i'G5 0,-44(- BL O j oO,t t S
1 - )MSrti4 $au/f , PLw,'A� F ,s -i &c.c
c-, Boa '- t Mid-clefl .
wi Completion of the followinKtable may be waived by the Inspector of Wires.
3 No.of Recessed Luminaires 12 No.of Ceil.-Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting
grnd. ❑ grnd. ❑ Battery Units
No.of Receptacle Outlets (2 / No.of Oil Burners FIRE ALARMS No.of Zones
No.of Detection and
,- No.of Switches o� No.of Gas Burners Initiating Devices
i No.of Ranges / No.of Air Cond. Tonsl No.of Alerting Devices
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❑ Monneunicictpalion 0
Other
C
No.of Dryers/suc,( ALFc, / 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.
n No.of Devices or Equivalent _
OTHER: w i2.r Ft 4-)I jiK/ sPL-;rid -. /1 E.L®edli1- 3M-vie 6.
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 9 OOQ — (When required by municipal policy.)
Work to Starts ", ^d ( 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 ES2 BOND 0 OTHER ❑ (Specify:)
I certify,under the pains and penalties of pedury,that the information on this application is true and complete. , r
FIRM NAME: /4)WB/4o Gd,�vfg i:LE eg-Ait:a) 1 LIC.NO.:& )S (c'
Licensee: F1)w/af a e/dp v,g Signature ,1‘0,,'s'/ LIC.NO.:
(If applicable.enter"exempt"in the license number line.) t,aT Bus.Tel.No.;SQA' ''/1 P7I
WSJ
Address: -SO-.21 )me_ ))i1/i j?ayuldia l`y 402 A 2 Alt.TeL No.:
*Per M.G.L.c. 147,s.57-61,security work regdires Department of Pu'blic 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:$