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Home My WebLink AboutBLDE-21-000360 Commonwealth of ti.—..,, Official Use Only Massachusetts Permit No. BLDE-21-000360 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:7/24/2020 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice 01 his or her intention to pertthe electricale owor e cribed below. Location(Street&Number) 476 ROUTE 28 ` ( af Owner or Tenant Telephone No. Owner's Address 476 ROUTE 28,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: Replace pool light, post light&five ground lights. 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 7 SwimmingAbove ❑ In- ❑ No.of Emerge gh Pool grnd. grnd. Battery Un• :its / No.of Receptacle Outlets No.of Oil Burners FIRE , S VIL.... No.of Switches No.of Gas Burners No.o . •ct' i o • Initiatine :•• O No.of Ranges No.of Air Cond. Total No.of Alertin �' n Tons U No.of Waste Disposers Heat Pump Number - Tons KW „No.of Self-Contained 0 O Totals: Detection/Alertine Devic No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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 Siens 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 4g. 7/27zot --- Official Use Only _ Commonwealth of Massachusetts ,, .� Permit No. t' - 0 O ` - Department of Fire Services Occupancy and Fee Checked jKev. I/WI - BOARD OF FIRE PREVENTION REGULATIONS (leave blank) APPLICATION FOR PERMIT T� PERFORM ELECTRICAL '.., ®i',K All work to be performed in accordance with the Massachusetts Electrical Code ),527 CMR 12.00 (PLEASE PRINT IN INK'OR EALL INFORMATION Date: 2h City or.Town of: A��C -VQ Q>7( To the I ector of Wires: By this application the undersign gives notice of his or her intention to perform the electrical work described below. Location(Street&Number): - Lf 7 l9 ✓ .....2se Owner or Tenant A ,<(2-- / J c-� ; 7 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 9 No E0 (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 Ls;; ;on and Nature of Proposed Elect 47 ,/1��L 0 T.. 7/ at��L 4—„/ 4.0 I I / Completion of the following table may be wain:'by the Inspector of Wires No.of Z mat No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets ....No.of Hot bs Generators KVA .t Yr No.of Luminaires Swimming Pool grad. 0 grnd. II Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alertin, Devices - p Nu.,t., ens o.a :.;, :tial No.of Waste Disposers Totals: - '--' Detection/AI ;tT!_ Devices ivlunici++ No.of Dishwashers Space/Area Heating KW Local"Connection "Other No.of Dryers Healing Appliances KW Secarliy No of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Teiecommunlations Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 Inspections 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 covedge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE El BOND 0 OTHER 0 (Specify:) I cert',under the pains and penalties of perjury,t tat e�rm this applica o is true and complete. FIRM NAME:John Brewer Electric ) 46414,, wpm LIC.NO.:E21949 Licensee. / lije 9' Signature f „_,,..- -N_ LIC.NO.:A14092 elfapplicable. enter 'exempt"in the license number line.} ;53 Bus.Tel.No.: Address: 73 Mil-../dl Ca' .0t=y/4-- 14." - ,444- l/�• £f'I l Alt.Tel.No.:508-367-0167 `Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER:I am aware that the Licensee does not have the liability insurance coverage normally required by law.By my signature below,I hereby waive this requirement.I am the(check one) Ev ner 0 owner's agent. Owner/Agent PERMIT FEE:Signature Telephone No.