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HomeMy WebLinkAboutBLDE-21-002725 Commonwealth of Official Use Only �E � Massachusetts Permit No. BLDE-21-002725 ` 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:11/13/2020 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 electrical work described below. Location(Street&Number) 150 GREAT WESTERN RD Owner or Tenant HAYS JOHN L Telephone No. Owner's Address HAYS DEBORAH A, 150 GREAT WESTERN RD,SOUTH YARMOUTH, MA 02664-2205 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: Pool installation&grounding. 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- 1:1No.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 ❑ Municipal Connection ❑ Other: 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: $85.00 (4-4-6kwo t1 czVtrie.sr3 ((6-5(2_,3r . etrAA ..acv ,24/2.0 eve__ _ _4% ,0Clb©Cl 410(24 Official Use Only Commonwealth of Massachusetts PermitNo. ��` �-7� r Department ofFr�Services t • Occupan and Fee Checked (xev. 1/07,1 �'lz_ V`0-4' BOARD OF FIRE PREVENTION REGULATIONS (leave blaul APPUCATIs N 1F•R PERMIT T.) PERFOR' ELECTRICAL \A.,OR::", All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 (PT.F.A.SE PRINT IN INK OR TYPE ALL INFORMATION) Date: it /41.4sy City or Town of (PcVrlla3U/fi To the I ector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number): ,A C 'n At A Owner or Tenant Y ) cyv ?7 'k4,/65 r'7 Wit( 1 J( 7„.44:2 Telephone No. Owner's Address is this permit in conjunction with a building permr Yes No 0 (Check Appropriate Box) Purpose of Building ,f` ' .S,c7G 7C,-r Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps / Volt Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity _- _ / Location and Nature of Proposed Elect 1JC � 1/� !\J � " C✓� ���C._ � 1 �-C > Co t,etion of the following table' be waived. the I� or of Fibres. ao No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA tv" P— 1''0. t. . t1 '—,.-.c 17it itt 1.._t No.of Luminaires Swimming Pool grad. grad. II Battery Units No.of Receptacle Outlets No.of Oil Burners : - ALAS }No.of Zones !'o.of Detecaoa and No.of Switches No.of Gas Burners Initiating Devices oral No.of Ranges No.of Air Cond. Tons No.of Alerting Devices: . Heat ramp i .,.,, r No.of Waste Disposers Totals•.I r etec loAtt/Alertin Devi ies ivtun►cipa Dishwashers S ace/Area Reatha KW Local Connection II Other No.of Dryers skiers .ace/Area ting Appliances KW Security• .Sy Devices ms:*or Equivalent No.of Dryers o.of W' riow No.of ater KwBallasts D No.of Duces or Equivalent Heaters Si''s etecommrm eadonsWvirbm: No.Hydromassage Bathtubs INo.of Motors Total'. No.of Devices or Equivalent O r H ER: Attach additional detail Vdestred 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 MBC 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 coverer is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE BOND El OTHER 9 he a(Specify:)ethis appllcatio is true and complete. I certify,trader the John pains aeriEe cine o f y/ �`1/ �Q _,�,f_n, 5 '-77 LIC.NO-E2.�9 FIRM NAME:John Brewer Electric 1 ( ��{ ill LIC.NO.:A14092 Licensee: .E;,11 'T� Signature O ..,e llfapplicable. enter 'exempt"in the license number line.) --'� " / Bus.Tel.No.: Address: 73 MAL-PA(�v i'7.41a..�1���( ,./77/14- I rf` Alt Tel.No«508-367-0167 Per MGL c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S Ii ISURANCE WAR:I am aware that the Licensee does not have the liability insurance coverage normalhr required by law.By my signature below,I hereby waive this requirement.I am the(check one) Elmer =(owner's agent Owner/Agent PERMIT j S Signature i elephone No. CM Lr/e3RE- ci e teen' - C