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Home My WebLink AboutBLDE-22-004646 "\`k Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-004646 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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:2/22/2022 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) 1 TEMPLETON PL 8 r Sj2.q Owner or Tenant John Santos Telephone No. Owner's Address 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: Replacement HVAC 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 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices 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 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Sinus 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: 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 t /# 341 (/77/ 11N 24) c 1 ( 271/ j. _______________ ... '. /7 L-ommonweaffh o/MaJJacliuietts official Use Permit 1. 2epaptrnent ol.7ire ...S7ervices :A 7,;;L:,4v:,•.,..;:, •,,J,7% v.......... ,„ BOARD OF FIRE PREVENTION REGULATIONS !_ROccupanc_‘.,.and Fee Checked 1 =;"•• i CH Ceave blank) • APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ail stork to be performed in accordance with the Nlasstchusetts Electrical Code(MEC). 52 CMR 12.00 (PLEASE PRINT Iv[VA'OR TYPE ALL IVFOILAIATIO.V) Date: D--- — )6 ___ ___ Cit y or Town of: . 0,{0 ()LA-v-1To the Inspector of Wires: By this application th.? undersigne ei\es notice of his or her imemion :, perform the eleci .•rica ,vork described helm . Location (Street& Number) ,1 (e6/100-ttir) c _c_L w- r Owner or Tenant Cr6 (iL__.A.LK:+0 Telephone No. GIC.G .3Etn 13(tO Owner's Address ..afill_ Q . Is this permit in conjunction with a building permit? Yes E No Li (Check Appropriate Box) Purpose of Building Utility Authorization No. — , Existing Service Amps / Volts Overhead I Undgrd D No. of Meters _ New Service Amps / Volts Overhead I Undgrd E No.of Meters — Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion. f the,,Violying table may he waived 1 the In vh'c'Thr 61 If No. of Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle) Fans 'ITransformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA _ Above F-7 In- r-i .'o.o ..mergency Lighting No.of Luminaires Swimming Pool grnd. I---: grnd. 1--' Battery Units i No. of Receptacle Outlets No.of Oil Burners i',FIRE ALARMS No. of Zones --i No.of Detection and No. of Switches No.of Gas Burners Initiating Devices ______, --_____ Total No.of Ranges No. of Air Cond. Tons ____P 'N;. o.of Alerting Devices . [Heat Pump Number 1 Tons 1 KW No. of Self-Contained . No.of Waste Disposers Totals: . i Detection/.Alerting Devices — 1 t----1 Municipal 7 No.of Dishwashers Space/Area Heating KW Local Lj Other Connection i ecurity Systems: No. of Dryers eating.HAppliances KWI No.of bevices or Equivalent _ No. o WaterNo. KNIX' No.of No. of Data Wiring: Heaters Signs Ballasts No.of Devices or E.uivalent elecommunications N iring: No. Hydromassage Bathtubs No.of Motors Total HP No.of Devices.,or_E tqliyAkit_. - -- — OTHER: .-irhh'h arldit,ot4t1 detail /1.ti,: ireti, or as o•cwired by;he Inspecim' Estimated Value of Electrical Work: (When required by municipal policy.., Work tc Start. Inspections to be requested in accordance with MEC Rule IC. and upon completion. INSURANCE COVERAGE: Unless‘vaiveC by the owner, no permit for the performance of electrical work may issue anless the licensee provides proof of liability insuran.:e including "completed operation" coverage or its substantia equivalem. The undersigned certifies : at such coveraec is in force, and has exhibited proof of sante to the permit issuing offic . - , CHECK ONE: INSLRANCEIE.--„BOND 0 OTHER 0 (Specit Li alkAC{s(ome -f:10- --. I certift, under the pains and penalties of pesjury, that the information on this application is true and complete. FIRM NASIE: C‘k ' Lei (i1/1<--- LIC. NO.: / Licensee: eaca .ecd_ Signature LIC. NO.:r).-739 e (It‘11,,olicchic. enter -C.I:i.771pi-..iy the 11;:enn s? umber '11(0.1 Bus.Tel. No.: -.,_.,co„ 72620:d-.3 Address: 1.0M_ ni r6, 1 et.Pl nr_ V pL,A4A-- Alt. Tel. No.: .54.5 737 elqc3-y *Per N.1.G.L. c. 147, s. 57-61. security work re..s,uires De artmesit 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:, E owner [:1 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: S