HomeMy WebLinkAboutBLDE-21-004686 0. . �C Commonwealth of Official Use Only
V£�s Massachusetts Permit No. BLDE-21-004686
�-0 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:2/18/2021
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below.
Location(Street&Number) 108 BERRY AVE
Owner or Tenant SCHATZ KATHLEEN Telephone No.
Owner's Address 108 BERRY AVE,WEST YARMOUTH, MA 02673
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: Great room&bathroom remodel.Wire ••• n
•
Completion o Pwl& e e7 the Inspector of Wires.
No.of Recessed Luminaires 20 No.of Ceil:Susp.(Paddle)Fans '• Total
Transfor 6 KVA
No.of Luminaire Outlets 6 No.of Hot Tubs Genera KVA
No.of Luminaires Swimming Pool Above ❑ In- No.of e e c L :• '
grnd. grad• Battery U ts>
No.of Receptacle Outlets 6 No.of Oil Burners FIRE ALAR1 f Zones
No.of Switches 16 No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump Number Tons K\\ No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 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 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME:
Licensee: Jon T Moreau Signature LIC.NO.: 22967
(If applicable.enter"exempt"in the license number line.) Bus.Tel.No.:
Address:9 Redberry lane, MARSTONS MILLS Ma 02648 _ _ 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: $185.00
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n_'v_-__ .t, c� Permit No. li� ._Lf�Cam7
__ _ ..Lepartment o`.jire)erviced
1 f_- Occupancy and Fee Checked
',, _e 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: 02/16/2021
City or Town of: West 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) 108 Berry Avenue
Owner or Tenant Miller Family Telephone No.
v Owner's Address 203 Otis Lane-Bay Shore, NY 11706
J Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box)
S Purpose of Building Residence Utility Authorization No.
CI—
Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
0 Number of Feeders and Ampacity
2 Location and Nature of Proposed Electrical Work: Great Room and Bathroom Remodel - Pool wiring
v Completion of the following1 table may be waived by the Inspector of Wires.
Total
,/) No.of Recessed Luminaires 20 No.of Ceil:Susp.(Paddle)Fans Tf
Transformers KVA
No.of Luminaire Outlets 6 No.of Hot Tubs Generators KVA
i Above In- No.of Emergency Lighting
No.of Luminaires Swimming Pool grad. i—i grnd. ® Battery Units
No.of Receptacle Outlets 6 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No. Initiatingon Detection and
16 Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
g Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
P Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other
P Connection ,
No.of Dryers Heating Appliances KW Security Systems:*
Y No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters KW Signs Ballasts No.of Devices or Equivalent
dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.H
Y g No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 33825.00 (When required by municipal policy.)
Work to Start:ASAP 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 ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Coastal Mechanical LIC.NO.:22967
Licensee: Jon Moreau Signature yi, 4anii LIC.N(3.•. 2A-,
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:5o8-737-8747 �,
Address: 21 L Fruean Ave-South Yarmouth, MA 02664 Alt.Tel.No.:508-326-9699 �'
*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)❑owner ❑owner's agent.
Owner/Agent PERMIT FEE: $185.00
Signature Telephone No.
1.• .