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Home My WebLink AboutBlde-21-002862 co Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-002862 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:11/18/2020 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) 22 RUN POND RD Owner or Tenant ZEOLI JOAN F TRS Telephone No. Owner's Address 22 RUN POND RD, 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.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: Replacement heating system 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 1 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 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: 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 I'll 14 ( -( "41A e&b, (-7.A. fill rLLr,1s.\ rrnnlonlerea[t!t o / ja_sac/Ic eEt r + ! •Ci ,.` - -- ___ - a c�-'�J M „ �elrartrnent o/....tire er'icrs �`�'� `�.44 O:;t an and f e Checked BOARD OF FIRE PREVENTION REGULATIONS 4 R.or. l 07,1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK A.11 uork to be p;rtor:u.:d la r.a.d.y:rce s:stit iiassacir .. s..._ LiCer I C:>;1:(ilf:( 1 C-" \f1Z i!ii (PLEASE PRIV1.IN INK OR T}'PL <`F- tI,-1 Tyo-A1 t1 L I Date: 1 l-- j - City or Town o n of: , T the Inspector o t Ipes: —~�Y 7 By this application the .indcrsigned .i',cs not' c othis or t'entio o 1-----`— to per )r o he electric:,:} work described&scribed below Location(Street& Number) 0 • b ik _______ Owner or Tenant ��y/�� /� Telephone--- _.�L�Ll_1. �-�3s J�-��---- --_i� I3 tlOBe�O. Owner's Address _ -- Is this permit in conjunction with a building permit? Yes r 7Li 10 ��,_ -- (Cfieck Appropriate Box) Purpose of Building�_ _�- Ltility Authorization No. Existing Service -_ Amps Volts Overhead IV Lndgrd 7No.of Meters — ____ __-- Ness Service Amps i Vohs Overhead ? l ndgrd �, t) \ , of \Ietel S Number of Feeders and Ampacit ` Location and `afore of Proposed Electrical Work: 1 _-_ --_-_-- -_._.._ — ..._ ..____ _________________ ___ -- —•----___ __ �L!)r17(c'!1[sl1 r :C'o!!I t:n�� Cf m; t 7,-;c.7!,; rllt +reC all nt' (,.;; .1 11r ,,' . No.of Recessed Luminaires I\o.of Ceil,-Susp.(Paddle)Fans i\o•of Total1 _____ _ _ __.__ —__ Transformers KV:� I No. of 1_uminairc Outlets \u,of Hot Tubs .______ _ 1 _ �G-enerators K�':� No. of Luminaires Swimming Pool : 6u\eC� lii - ;�ii:of Emergency i.tghltii;' i __�______.______.---____-. _ __-- l grnd. a kl'tltl. 1 �Battc'ry ['nits _ 1 No. of Receptacle Outlets No.of Oil Burners F'tRl: :;L:1R\t5 \u.Of loner-^ No. of S�sitches No. of Gas Burners - <\o.of Detce on and __�_ r- of---tcli ----- -__ Initiating Devices \u. of Ranges f\o.of Air Cond. _ 'Total � iu. of Alerting Dc\ices __ Ions - i g f{eat�um ' lurn er 17 ohs ,KW — --__ \o. of Waste Disposers p ti\u.of Self-Contained _ Totals: ; ;Detectivt►iAterting Devices _ No. of Dishwashers _...- 4Space Area Heating KW Local❑ Municipal `-1 Other - ,_.____._ _---- - Connection \o, of Dryers �tleatin„ Appliances hid - -iSecurit� vstems:* --- _..1 { _ to of Devices or Equivalent O. of Wal _.__--___ 1No. of .- No. of _ !Data Wiring: ---1 Heaters_ _ Signs__ Ballasts No.of Devices or Equisatent �NC,. IlEdrer3?ttssagr Bathtubs- ,\n of tlotor. Total HP -tl'elecommur!,can is'1\firing: -----; -_._____. Io.of Deices or Equivalent I t.tirll i?.l:iil i.,..rc or{ IICL..<Ll ii [1. ! [fit" !c __ ' ____ , c[ ` — --- ':\rat required by it:ni.;p i rc,lieis 1\ :s to start Inspectlons to be retraested in accordance\l ith i o!IC l l;do r INSURANCE COVERAGE 1 hies ss I..c. the ov.ner. no permit for 1'e perior i1.14C U eiec:r \s,ork I,L:c i.suc Ln1 ., the h.:ensc.:provides proof of liability insurance including completed operation.'co` 'g ' r 'file. , r `' t � t>> 't t' .i �c'lii'..::CnL !}�. tinilcr�yna certtficr that iuCh 'ii.'er, ,s 'it foe C. and has exhibited proof +f S,Ill] r it I lr: l 1l,.4 I ,�tr f 1t \)S:rel t HE( ()Nil: i\St R,AyC.'t- Hc)�I) c>1 rtr.ti ( .: is,,4 ,- , wt'trs c_ Grtt 2/ t ia�i (, I,//' /�c`��jI certify.under the pains and penalties ofp'rjurr,tli t the information on this application is true and complete. !O� FIRM NAME: V1/4) ' Licensee: l('i L D(/ ( ) Signature _ -- -- LIC:. NO:.: a7T3�iL (1![!j?Il)f !)fie. C'It!['P 't',ln'C�'1)1�Ui I!P 717C'Ile ',1 [ t1;Ult eft' r 1 :'7 •""'" -- Address ot.1 I r uli If (k(�\V IA) A�GiY yi/t 1L; 3 Bus,Tel. No.:- u, ��°0 77 `? 7�} 3 "Per �, (i L. c. 147. ;^ 1 work _Public i V.-( _ Alt.'1 el. No,:i ii 73.2_.Y )--7 6 security requires Department of Safety"S" License: Lie. No.OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not ha:(''the liability insurance coverage nomiall\ - required by lain. Hy my signature below. I hereby waive this requirement. I am the(check One)7 owner [j owner's agen:. OM ner'Agent Signature _________ _—` _ Telephone\o.---� PERMIT FEE: