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Home My WebLink AboutBLDE-19-002628 Commonwealth of Official Use Only E_, Massachusetts Permit No. BLDE-19-002628 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 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 INFORMAT/ON) Date:10/31/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertomr the electrical work described below. Location(Street&Number) 66 HOMERS DOCK RD Owner or Tenant GLODIS PATRICIA A Telephone No. Owner's Address 66 HOMERS DOCK RD,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 ❑ 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: Replacement panel 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 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 ❑ 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: JOHN H BREWER Licensee: John H Brewer Signature LTC.NO.: 14092 (If 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: $50.00 `® <!b-he t- ti. Commonwealth of Massachusetts OUse.,y vi 111 W. caH••=9 ...- lJo sp.a4/IL-I . 1Department of Fire Services Permit No. , iY Occupancy and Fee Checked "' a-.: BOARD OF FIRE PREVENTION REGULATIONS LKev. 1/U/j (leaveblank) _. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 a+ • 12.00 (PLEASE PRINT IN INK ORTYALL FORMATION) Date: 1Q / / . City or Town of: f i (/ To the Inspe for o ' fres: By this application the undersigned v�4 n9tice o s or her intention to the electrical rk described below. Location (Street&Number): — (0 lye r�� Com' �Q'/< Owner or Tenant T. if R?y Lrj vC7 J 5 Telephone No. Owner's Address Is this permit in conjunction�with a building permit? Yes ❑ No ❑ (Check Appropriate Box) / Purpose of Building / -. ��,Fyj��'t/(''f_ Utility Authorization No. Existing Service ✓°C/`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 geS G/9 C ,Ei44 , ,e7rA/6 L 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- No.or emergency Lighting No.of Luminaires Swimming Pool grnd. II grnd . II Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.ofDetectionand initiating Devices total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • beat Pump Numt cr Ton .KW No.ofSelFCoMaio No.of Waste Disposers Totals: ` — — Detection/Alerting Devices Municipal - No.of Dishwashers Space/Area Heating KW Local Connection IIOther No.of Dryers Heating Appliances KW Securityo 0. Devices or Equivalent No.of Water KW 'No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent telecommunications Winng: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail IIfdesired 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:) feedlot,under the pains and penalties of perjury,that the informed• . this application Is true and complete. FIRM NAME:John Brewer Electric LIG NO.:E21949 Licensee: Signature - LIC.NO.:A14092 (/fopplicable, enter"exempt"in the license number line.) Bus.Tel.No.: Address: 73 Mi LLM Cr-, f?9fV,/)'l ori ri, - -.•r h9.'L(.S inea aR(try Alt.Tel.No.:508-367-0167 '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) Brier 0 owner's agent Owner/Agent Signature Telephone No. PERMIT FEE:$