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Home My WebLink AboutBLDE-20-003518 Commonwealth of Official Use Only /E�1� Massachusetts Permit No. BLDE-20-003518 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 INMKOR TYPE ALL INFORMATION) Date:12/19/2019 City or Town of: YARMOUTH To the Inspector of Wirer: By this application the undersigned gives notice of ors or net intention to perform use electrical work described below. Location(Street&Number) 35 GLEASON AVE Owner or Tenant SIMPSON ARLEEN F(EST OF) Telephone No. Owner's Address 35 GLEASON AVE,WEST YARMOUTH,MA 02673 Is this permit hi conjunction with a building permit? Yes 0 No Cl (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: make misc.repairs to kitchen and basement area electric Completion of the folltnvMg table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Total Transfornten KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires - Swimming Pool Above 0 lo- 0 No.of Emergency Lighting grad. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.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 Hat Pomp I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Munidpal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Deuces or Eauivaknt No.of Water KW No.of No.of Data Wiring: Heaters aliens Ballasts No ofDevices or Eanivaient No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Univalent OTHER: Attach additional detail(desired or es 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 thin application is trite and complete. FIRM NAME: ERIC W DREW Licensee: Eric W Drew Signature LIC.NO: 13118 (fapplicabk,enter"exempt"in the license number line.) Bus.TeL No.: Address:103 MID TECH DR,UNIT A.W YARMOUTH MA 026732588 AIL 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:S50.00 • L *A4141., cobIJ L igJ LLttGf/ m&4(1( 0164 `f t (ZO i (SOXIiteraitliV64913 fibi2N1941r14o p► tu. 5) or Commonwealth of Official Use Only • 'E Massachusetts Permit No. BLDE-20-003518 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:12/19/2019 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) 35 GLEASON AVE Owner or Tenant SIMPSON ARLEEN F(EST OF) Telephone No. Owner's Address 35 GLEASON AVE,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: make misc. repairs to kitchen and basement area electric 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 Ab ❑ In- ❑ No.of Emergency Lighting griove d. grid. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1e01 Zones No.of Switches No.of Gas Burners No.of Detection Initiating Devices No.of Ranges No.of Air Cond. Total n No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 0 r: 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 Signs No.of Devices or Eauivalent 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:$50.00 ��a�� , - -a• --.A.'-'2 ''. ' -1,4. , .. - • - ' -- -'1',;,.• ' - ; - .....- _ _ ,- 1S7-3 1A-Nr•) 04 e-I4 _ <---- ........... _ 161(ut tV9° 0•,,A,,, / (XjtjtU1)' c21-1,01 tq E230— 3 c;I 18 .6L'QC.) 2-t ce(7-0 \