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Home My WebLink AboutBLDE-21-005813 , ti., otti, Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-005813 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:4/8/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electncal work described below. Location(Street&Number) 51 SMITHS POINT RD ,4 Owner or Tenant Great Island Homeowners Association Telephone No. ✓ _ Z Owner's Address (/ z Is this permit in conjunction with a building permit? Yes 0 No 0 (Chec i 4.; 1 • is • tto Purpose of Building Utility Authorization No. . 4)/14.12-t?----/)) Existing Service Amps Volts Overhead 0 Undgrd 0 No. • New Service Amps Volts Overhead 0 Undgrd 0 No.of Me ers Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace panel&light on dock. SMITH POINT ROAD DOCKS) 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 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: JOHN H BREWER Licensee: John H Brewer Signature LIC.NO.: 14092 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:205 CEDAR ST,W BARNSTABLE MA 026681324 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: $80.00 Y ` Commonwealth ofMassachusetts OfficialUse— 0 Permit No. �` S C ni Department of Fire Services oceupmr and Fee Chet d z.zr Occupancy 1I(T BOARD OF FIRE PREVENTION REGULATIONS (leave APPLICATION FOR PERMIT TO PERFORM ELECTRICAL W '`,K All work to be performed in accordance with the Massachusetts Electrical Code M 11 00 (PTRASE PRINT IN INK OR TYPE ALLORAItt IOOt19 Date: `Jt 7 <4 1 City or�'Town of: yt ,( �(i To the I ecto of Wires: --1- By this application the undersigned gives notice of lis or her intention to perform the electrical work described below. Location(Street&Number): -,---S"..,47/7-X-1-,,,q17 -Y/ A (7C'c--/c_ .., (}caner or Tenant ": / 0, a . ..r 4' ir_".ii► Telephone No. QOwner's Address 0 Is this permit in conjunction with a building permit? Yes0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps I 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 Elect . f< / (r _l�� Q'C'J S °i AZ�4..c $.,L / /-77i"C/( c '-" l-_ Co,",etia►:-of the ollow •table ,,• be waived , the I Y, or of Wires. 1a , No.of Recessed Luminaires o.of CeiL-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tuias Generators A e -.1- 1-t. 4 _ a ' .di .-EI,li iii• No.of Luminaires Swimming Pool grnd. D and. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners ME ALARMS JNo.of ZoeN,o.of Detection ani" No.of Switches No.of Gas Burners Initiating Devices 0 No.of Ranges No.of Air Cond. Tons No.of Ale 'i, . Devices ReatPimp 1,...,- ins 11111 De€ectTtottl- Y„ • Devices.., No.of Waste Disposers Totals �. • ElOther 1= KW Local"Connection Other No.of Dishwashers S': �� - r " o.of ryers A=a Appliances Smartt, of Devices or Equivalent `o.of No.of Data Wiring 'o.of*'iter it Ballasts No.of Devices or Equivalent S ons Wang: Heaters No.of � Total$P .of Devices or Equivalent ( No.Hydromassage l3aBrLrrhs OT I a.R:— Attach addbional detail Pfdesired oras 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 cow pletion 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 covge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE Er BOND 0 OTHER II (Specify:) , . e and complete.FIRM NAME:John Brewer Electric . fp er thebfermisr, ,z, apps! cati I cert f}►,tiunderdie ppainsandpetruliies o erjury,tV — / ' ,4 ,/ LIC.NED.F2199 : 1..a.:**,..a.:**, . .4,,,- s Signatu& 4' - — LIC.NO.:A14092 Licensee: �':�/� I'�� Bus.TeL No.: (If applicable enter rPxempf•,in rhe license number lined-. iN1 .2,,' ',, le :} Alt.Tel.No.:508-367-0167 Address: 73A�A� C- '_ �--.fd. _ _ - of Public Safety S"License: Lic.No. *Per M.G.L. c. 147,s.57-61,security work requires Department " coverage normally OWNER'S - - r, • C WAIVER:I I aware that the requirement does Ir am ave the the(check liability insurance Etter E owner's agent. required by „k s' =t below,I hereby waive this OwnerlAg- Telephone No 3 (.....?2_(..-17— PERMIT di/ /C ayam - e