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Home My WebLink AboutBLDE-18-003659 Commonwealth of OffiUse only or`rN E _ Massachusetts Permit No. BLDE-11I-003659 cial +��%/ BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked . [Rev.1/071 ' 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:12/21/2017 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of nis or her intention to perform the electrical work described below. Location(Street&Number) 11 NIAGARA LN Owner or Tenant WELSH DAVID L Telephone No. Owner's Address WELSH DOROTHY J, P 0 BOX 36, ROWLEY, MA 01969 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: install light and outlet in crawl(508-778-0723) 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 Above In- No.of Eme No.of Luminaires SwimmingPool ❑ 0 rg' grnd. grnd. Battery l t s _ No.of Receptacle Outlets No.of Oil Burners FIRE • ,J , i. ' /�_ No.of Switches No.of Gas Burners No.of D - .,:i,! � n O `� Initiating De t No.of Ranges No.of Air Cond. Total No.of Alerting DevRes / -Q Op 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 a Othe Connection Vy74 No.of Dryers Heating Appliances KW Security Systems:" No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Sirs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTIIER: Attach additional detail rfdesired,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: Eric W Drew Licensee: Eric W Drew Signature LIC.NO.: 13118 (If applicable,enter"exempt"in the license number line) Bus.Tel.No.: Address:103 MID TECH DR,UNIT A,W YARMOUTH MA 026732588 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 Commonwealth of Massachusetts Official Use Only " t 'i Permit No. &DE — /V—0) $67 a, „ „1;� •„ Department of Fire Services J4) Li Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/OSj (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPELL INFO TION) Date: (a -1q--{2 City or Town of: a(/ To the Inspector of Wires: By this application the undersigned yt s notice of his or her intention to perform the electrical wo k deee ribed below. N ocation(Street&N ber) ( ( a.. - • Cc). Q kOwne'fr or Tenant Cat Q C V1 Tel phone No. 6 3j i78 0i ill \t ties Address ts • .r.:: Fath s permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) o' id=kir ose of Building Utility Authorization No. C\i Exl tag Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters kntJ W fre4ervice Amps / Volts Overhead❑ Undgrd ❑ No.of Meters0u berof Feeders and Ampacity 1/ .d talon and Nature of Proposed Electrical Work: (,41$-\-q U�y� di kik- 1 ^t (Aaft Completion of the following table may be waived by the inspector o ares. No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Tof Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of 011 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 AlertingDevices Toos 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❑ Monneunicictiotaln ElOther C No.of Dryer, 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!fdesired,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 op�ffic c verage is in force,and has exhibited proof of same to the t issuir�, e. CHECK ONE: INSURANCE (� BOND 0 OTHER 0 (Specify:) kJ IG'COmx p/cul fill rTy 8 -as -6 I certify,under the pains and enalties of perjury,that the information on this application Is true and cSmplete. FIRM NAME: Et" ed (44 e„...--- LIC.NO.: /31/9,4 Licensee: Signature IL C.NO.:)fl 1 t Address:applicable, ` V p�y�AC q e nur''4.71 kb 4 f J w t, 14__ Bus.Tel.No.Sas 776 d7 .3 Mid ( MYr {�jV( UTVi f(/VT Alt.Tel.No.:Cf7i7 tis?/ "Security System Contractor License required for this kb if applicable,enter the license number here: 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 0 owner's agent. Owner/Agent PERMIT FEE: $ Signaturetura Telephone No.