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Home My WebLink AboutBLDE-21-003547 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-003547 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:12/26/2020 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) 16 HEADWATERS DR Owner or Tenant SIDERIS MARK Telephone No. Owner's Address SIDERIS MARYBETH,30 UNION STREET,WATERTOWN, MA 02472 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: In-ground pool Completion of the following table maybe 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 Imtiatine 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/Alertine 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:$85.00 Tilt eArH 5:461-Li3o' /</2,dz i 4 C 1) -Q. 69/2 i,t� t•N7/2' Z'rc tea, Oficial Use Only Commonwealth of Massachusetts Pei3nit No. 1.-=2( -3.51-0 �k -_'t Department of Fire Services Occupancy Fee Checked r 4 ,,,, "z' BOARD OF FIRE PREVENTION REGULATIONS [Key. I n(1 J and Fee Checked ... APPLICATION FOR PERAT TS PERFORM ELECTRICAL VV. RK All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 CMR/ 12.00 (pJ.RA.SE PANT IN INK OR TYPE T INFORMATION) Date: Jc .2_/-2C7' City or Town of: /(iyx2 /� To the Inspe or of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number): /`Q j� 9 W 7-6-)1..S R ,1) Owner or Tenant .: I7J, �, CS/,t )c`7T?l Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes I No 0 (Check Appropriate Box) Purpose of Building /1 ,—� ' — (/CC_ Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Elect /2_ (i' ,�•G L�u J c--1.--- , Completion of the following table may be waived by the Inspector of Wires No.or Torsi No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA A covesn- No.bmergency Lgnung No.of Luminaires Swimming Pool grad. ❑ grad. ❑ Battery Units p, No.of Receptacle Outlets No.of Oil Burners FIRE - - ' — .$ . ,- No.of Detection a . .. No.of Switches No.of Gas Burners— Initis a t T_ ces F • '�. �'.; Tata s No.of Ale = a vtee�C 28 �� »t i No.of Ranges No.of Air Cond. ?p20 p umc ort oa .•� No.of Waste Disposers Totals: "'� Detection/ -''t, No.of Dishwashers S ace/Area lectin K'iV Local Conneebt�e t 601-'7-'4 No.of Dryers Heating Appliances KW Security Systems.* Pio.of Devices or Equiivalen • No.of Water RV No.of No.of Data Wiring: HeatersSigns Ballasts No.of Devices or Equivalent 1 etecommunicatl'ons Wiring: No.Hydromassage Bathtubs No.of Motors Total DP No.of Devices or Equivalent OTH ER: Attach additional detail ifdesired or as required by the Inspector of Wire._ 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 5 BOND 0 OTHER 0 (Specify:) I certir,under the pants and penalties ofperjury,p�erjury,Oat the inform._ K....,/.1-A4/0O,flits gpplictttt is trace and complete. FIRM NAME:John Brewer Electric '�Ai Ot t-:l"'i;.#1.1'.....2-L..4,--,...,----.._ 111 LIC.NO.:E21949 Licensee: ..' % Signatur (,-- 4 ^��----.._ LIC.NO.:A14092 llfapplicable. enter 'exempt"in rhe license number line.) Bus.Tel.No.: Address: 73 AER./fl C / 4ç7./1;0�� t ."-f /k.7 •4 OR i`'4 Alt.Tel.No.:508-367-0167 *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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) Ener 0 owner's agent Owner/Agent Signature Telephone No. PERMIT FEE:$�J ( / / 3/cl e ,y�r • Q "