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Home My WebLink AboutBLDE-23-004095 • Commonwealth of Official Use Only E Massachusetts Permit No. BLDE-23-004095 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 Codc (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:1/25/2023 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) 923 ROUTE 6A UNIT N Owner or Tenant CHAPTER TWO LLC Telephone No. Owner's Address C/O IVANA LIEBERT, PO BOX 206,YARMOUTH PORT, MA 02675 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: Replace EBU &receptacles. (BUILDING 4/UNIT N) 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 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. Tonal 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 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 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: CORY J WALKER Licensee: CORY J WALKER Signature LIC.NO.: 54207 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 110 Sheffield Rd, Brewster MA 026312860 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: $80.00 ( . Z 9 Z C ... R E .� V E D Casnso+uusa/th o1 a. Bette Official Use Only __ Permit No. �7 - 4 C q c� .U tme n t a�cc77 {� : _- A! +23 epa+ .tire J�xricel J Occupancy and Fee Checked BOA'D OF FIRE PREVENTION REGULATIONS [Rev. 1/07) BUILDING DEPARTMENT (leave blank) ay. -.± ION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 C R 12.00 . (PLEASE PRINT IN INK OR TYPE ALL INF /NATION) Date: 1 J7 3 2 City or Town of: ; ('\fof\kC U 1 f To the Inspector of Wires: By this application the undersigned jives notice of his or her intention to perform the electrical work described below. Location(Street&Number) e\aT3 ��- ,P)- �11�\�C. (-4 _ A 1-- (� Owner or Tenant taA D ' r J 3 r �'/ LL� Telephone No. �Ch� L/93--y3 J Owner's Address l:.St? C-C_t:,,rCkY`Ck vf\( ' IN\- \.l`S�a- A-)V•CS Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd dg ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: .zAr L 1L �� Yeas Y-e_. "1iXc;_41 ()7CA L111 r'�vk�A-uc1,2s �, 1/4 f)CkUciy tv ) �� r, ic,-f- rnc)c is . Completion of the followihg 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.ot-Emergency Lighting grad. grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners ,No.of Detection and d- Initiating Devices 11 No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump J Number ,Tons KW 'No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW !Local 0 Municipal 1 Connection ® 1 No.of Dryers Heating Appliances KW security Systems:* No.of Water No.of Na of Devices or Equivalent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: !� C Attach additional detail ifdesired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: ,, ) L (When required by municipal policy.) Work to Start: I )27I715 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 IN BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete FIRM NAME: LIC.NO.: I2.(5 -` ) Licensee: 076. j k,,44,�,J ' Signature C .- afapplicable, enter x t"i�t e li e e n r line.) LIC.NO.: 51 Address: 1 t 0 "ANC ie ti? Bus.Tel.No.: 5Cl1 i lr-1t- t11 *Per M.G.L. c. 147,$. 57-61, security work requires Department of Public Safety"S"License: Lic.No. Alt.Tel.No.: `j -411 C �1 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 ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ .5-�J f