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Home My WebLink AboutE-19-592 tJ of Commonwealth of Official Use Only "E Massachusetts Permit No. BLDE-19-000592 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 'Rev.'/071 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:7/30/2018 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 dee wo des Location(Street&Number) 32 MAYFLOWER TERR Owner or TenantaD Telephone No. Owner's Address • _ • .aays.rs -- ,..:.:.:_....•. • .- 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 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace pool wiring. 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- a 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 -InitiatinE 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 ❑ 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 Sins 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: JOHN H BREWER Licensee: John H Brewer Signature LIC.NO.: 14092 7f applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:205 CEDAR ST.W BARNSTABLE MA 026681324 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:$85.00 C�.0 pj/Uu 647771-0) )/s,/8 Sri& l0(30(3 Vii/ Official Use OnlyCommonwealth of Massachusettsp, yr is vii Qi Permit No. EA — 05 l wrl - ii Department of Fire Services _ _I a LlOccupancy and Fee Checked "^,, BOARD OF FIRE PREVENTION REGULATIONS tj (leave blank) - APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ,527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE LL INFORMATIOIIJ Date: 7 /- City or Town of: Ve} 4C/YF{ To the Insp ctor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Numbe ): c 34 MA y rz ci)/va'P Y1flC. 1 Cr Owner or Tenant L 4(J/_ i CI g/r—r—.ey Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 12( (Check Appropriate Box) Purpose of Building /fE'S./c2/CC:: 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 Elect KCsc cel CE �� 1.4,tin, 'c/A' i-7/' ,/HC 4ir7 Z. c5Hc0 Completion of the following,table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot tubs Generators KVA AboveIn- Nb.of Emergency Lighting No.of Luminaires Swimming Pool grnd. Li 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 t n and Innitiaati ting Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices {feat Pump Numter Tons KW No.or Self-Contained No.of Waste Disposers Totals: ------"'-'--" Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local" Connection "Other No.of Dryers Heating Appliances KW SecuritydDems:* No. or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Winn(;: 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. 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 cov ge 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 informed this application Is true and complete. FIRM NAME:John Brewer Electric LIC.NO.:E21949 Licensee: Signature at...4,-•-A------.._ LIC.NO.:A14092 (Ifapplicable, enter"exempt"in the license number line) Bus.Tel.No.: Address: 73 Mi LLRq ar f,gf(/,J,414.-1 -..r 4044,5 01,9 rA.e7&55,ts Alt.Tel.No.:508-367-0167 'Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER:I ant 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) Etner "owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $