Blde-22-003282 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-22-003281
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:12/9/2021
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) 389 WHITES PATH
Owner or Tenant Steven Cole Builders Telephone No.
Owner's Address
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: iNSPECTION&PERMITTING OF WORK DONE WITHOUT PERMITS.
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. Totalo No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained
Totals: Detection/Alertine 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 Eauivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Siens 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 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:$260.00
3-1 tU fit CO-Le
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Loolownweak oi Mai.sachaieili , urti—eial C----se Only--
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Permit No. zi-32-6(
- --w-73_,-.
, .:, ,- , Zepariment a/ ire..Service.3
DEC til -.,1'?"
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.•, -4,:,d: BOARD OF FIRE PREVE Occupancy and ee CheckedNTION REGULATIONS • - '
____ •,-..b.. .
112;\ (!Q.‘. L.hankl ---- '
,
BUILDING DEPARTMENT
BY:---AppucATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All cork to be performed in accordance lwith the\Lissachusts Electr1 Cod, (NfEC). 52"CAM 12.0()
(PLEASE PRINT 11\'INK OR TYPE ALL INFORAt-iTION) DateLLajf 7-- - -__(_________
City or Town of.
• Varyll
_ To the Inspector of Wires.' _______By this application the undersigned g \es tiof his or h4:1-inlyition .0 perform t -( el-ctrical A ork described below.
Location (Street& :•'4in ber) ki
.,---
Owner or Tenant 7 ,
Telephone No.
_
Owner's Address
Is this permit in cork'unction with a building permit? Yes LI No ! (Check Appropriate Box)
Purpose of Building
Utility Authorization No.
Existing Service Amps / Volts Overhead — Undgrd 7 No. of Meters
New Service Amps / Volts Overhead ! 1 Undgrd 1 No. of Meters
----
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work. 1
• „.„ ,
Coln)1e6 n,)1 th-i yi.dloiling whie mov 1:e; aireci in t te hrTector of Irii s.
-----
7*-----TSW.Tr— Total
No.of Recessed Luminaires No.of Ceil.-Susp. (Paddle) I.ans
!Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KV.A
-
Above 1--- In- r---1 . o. o nreigeThieyTighting
No. of Luminaires
Swimming P"1 grnd. L---- rnd. !----1 Battery Units
No. of Receptacle Cutlets No.of Oil Burners !:FIRE ALARMS INo.of Zones
I:No.of Detection and
No. of Switches No. of Gas Burners
Initiating Devices T Ail
No. of Ranges No. of Air Cond. THIS No. of Alerting Devices
—
'eat Pump 1 Number TonsKW ,N(-----L-7: 1—cl*.fe 1-75-rifiliTed .
No. of 1Vaste Disposers
Totals: I Detection/Alerting Devices
r--, Municipal 7 ,
No.of Dishwashers Space/Area Heating KW
[1--"al 1.---1 Connection i___, Other
'Securit7syste77
No. of Dryers "------r
Heating Appliances KVI.
No. of bevices or E9uivalent
_
No. of Water Kw No.of ----N-67o f Data! Wiring:
Heaters
Signs Ballasts I No.of Devices or Equivalent
No
'Wiring:
No. Hydromassage Bathtubs No. of Motors Total HP
I No.of Devices or Equivalent
OTHER:
, —Attach adc0non.il./41‘0;0 du,/,ed. or(Ls-,.equired by the inspc.-c tor of it'fro.
Estimated Value of Electrical Work: (When required by municipal policy.
Work to Star: Inspections to be requested in accordance with MEC Rule IC. and upon comp'etion.
INSURANCE: COVERAGE: Lnless \vai\c.c by the owner, no permit for the performalce of electrical \vork may issue .mless
the licensee provides proof of liability insuranee including"completed operation"coverage or its substantial Null.alem. the
undersiened certifies flat such co\eraue is in force. and has exhibited rroof of sa!,21, to the permit issuing oftic'. f
CHECK ONE: INSLRANCEBOND 0 OTHER 0 (Specil.y:l (Aa-A,61C{S(Oky
1 certift,under the pains and penalties of perjury. that the information on this application is true and complete.
FIRM NAME: C \ , C____
LIC. NO.:_13115A—
,
_Licensee: eiTc__. Lx-.eLd Signature ___ _______ LIC. NO.
rIf appIic chic. ,..,:prer -c,Avnipt. .itlu.':icens,ntimL, r inte.f
13us.Tel.No.: p72S
Address: 1,42I . , Alt. Tel. No.: 05 77
*Per NI.C.L. c. kr. s. 57-61,security work re:tuires De arm,. .t of Public Safety "S"License: Lie. No.
OWNER'S INSURANCE WAIVER: I ant a.,‘are 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(cheek one. E owner Q owner's agent.
Owner/Agent
Signare
-- ---
Telephone No.
PERMIT FEE: S 4r: to D
—_____--
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