HomeMy WebLinkAboutBLDE-20-004361 Commonwealth of Official Use Only
1 , Massachusetts Permit No. BLDE-20-004361
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
JRev.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:2/7/2020
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) 131 PLEASANT ST
Owner or Tenant COOPER ERICK W Telephone No.
Owner's Address P O BOX 1048,SOUTH YARMOUTH,MA 02664
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.o eters/'\
New Service Amps Volts Overhead 0 Undgrd 0 No.of r EJ1it\
Number of Feeders and Ampacity ic")),....
Location and Nature of Proposed Electrical Work: Wiring for master bedroom/bath addition.Install smoke detectors.
Completion of the following table may be waived by the Insp- tor 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
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No.of Switches No.of Gas Burners No.of Detection and
Jnitiatine Devices
No.of Ranges No.of Air Cond. 7 Total No.of Alerting Devices
o
No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained
Totals: ,Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal El Other:
_ Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of B las Data Wiring:
Heaters Signs �/[SSNry�o.of Devices or Eauivalent
No.Hydromassage Bathtubs No.of Motors Total 4. < V ecomm ions Wiring:
evices or Eauivalent
OTHER:
Cc/71ttac •••-i. r j ed,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: re•by mu t y {J,J S/ /
Work to start: Inspection to be requested in...4,��� C Ru 0 t n Ldmpletior(. / 2,
INSURANCE COVERAGE:Unless waived by the owner,no permit for the per o.t r 7• c 'cal woo unless the licensee provides
proof of liability insurance including"completed operation"coverage or its substantial equiva e understgtifies 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: Mark H Chase
Licensee: Mark H Chase Signature LIC.NO.: 8669
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:21 DRAKE ST,YARMOUTH PORT MA 026752204 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 ant the(check one) 0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$155.00
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Commonwealth of Official Use Only
A; Massachusetts Permit No. BLDE-21-003235
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:12/7/2020
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) 131 PLEASANT ST
Owner or Tenant COOPER ERICK W Telephone No. O
Owner's Address P 0 BOX 1048, SOUTH YARMOUTH, MA 02664
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box Q
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters
4) '6
New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity _
Location and Nature of Proposed Electrical Work: Renovations per attached (Up to four inspections.)
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. Total No.of Alerting Devices
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 Municipal ❑ Other:
Connection
No.of Dryers Heating Appliances + Security Systems:*
AINo.of Devices or Equivalent
No.of Water KW No.of .a Data Wiring:
Heaters Signsillei No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors ► Telecommunications Wiring:
C'j No.of Device or Equivalent
OTHER: V 4,/'/22
0 w h i ail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: i'• t. 're. • Mi i.•1
Work to start: Inspection to be requested i ` co:nt! . M.i ' - I` upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the perf. e of ele may issue unless the licensee provides
proof of liability insurance including"completed operation"coverage or its subst.pelf./
equivalent.Th•ti signed 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:)
1 certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Mark H Chase
Licensee: Mark H Chase Signature LIC.NO.: 8669
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:21 DRAKE ST, YARMOUTH PORT MA 026752204 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: $230.00
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