The URL can be used to link to this page

Home My WebLink AboutBlde-22-001175 Commonwealth of Official Use Only EE` Massachusetts Permit No. BLDE-22-001175 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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:9/1/2021 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) 191 MID-TECH DR Owner or Tenant TIERNEY JAMES Telephone No. Owner's Address 191 MID TECH DR,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: Remodel bathroom. (SPINAL TECH) 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 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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 ❑ (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 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: $100.00 ZUal. fq7-e(Zi .. C1\161.- l ( f2 - Commonwealth of Massachusetts `— official Use Only Permit No. ,� Department of Fire Services 1 76- Q Z ."': _% BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked lw [Rev. 9•'OS) (leave blank) 1 ; N 7 ,H 1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK .� 1 All work to be performed in accordance xv ith the Massachusetts Electrical Code(MEC),52-CMR 12.00 l.L!I c� f EASE PRINT IN INK OR TYPE. LL I VFOR • TON) Date: 22 � ) (� ' = Z City or Town of: tr��y,/ g U7 °! rii'�11 To the Ins ctor f Wires: .Q pB. this application the undersigned giy n tice )f his r er-intention to perform the electrical work described below. jL cation (Street& Number) °36 ner or Tenant S((� Owner's Address �Q` 'e Telephone No. Is this permit in conjunction with a building permit? Yes No pi (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd _ No.of Meters New Service Amps i Volts Overhead Undgrd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: tt )1 ter to c_ � m Completion of the following table may he.rained hr the inspector of ll'irec. 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 i FIRE ALARMS INo. of Zones No.of Switches No.of Gas Burners 'No.of Detection and Initiating Devices Tota No. of Ranges No.of Air Cond. Tons 'No. of Alerting Devices No.of Waste Disposers Heat Pump Number Tons s No.of Self-Contained Totals: I �.. ..KW ;Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal Local❑ Connection ❑ Other No.of Dryers Heating Appliances KW ecu' rity vstems:* No.of Water No.of bevices or Equivalent K«' 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 i/•desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: inspections to he 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 EL BOND ❑ OTHER ❑ (Specify:) A,(AC((j c r J lie Ci' g(a-0-1 I certify, under the pains and penalties of perjury, that the information on this application r•true and coonplete. FIRM NAME: -E-\ j(A.ki LIC.NO.: ( 3( j5 4 Licensee: C bre uj Signatures C //l applicable:Ot ct`mpt 'in th lie r rrr other lirr'.l �` LIC. NO.: }7�3 l Address: ` Pc �,(j� �% ,�/r/ toit Alt./t� Bus. Tel.No.:.5 7 TS 7�3 *Security System Contractor License required for this work; if applicable, enter the license number here: l. No �� 73? j �-7 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hare the liability insurance coverage normally required by law. By my signature below. I hereby waive this requirement. I am the(check one) Ei owner ❑Owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: S /(31)