HomeMy WebLinkAboutBLDE-22-000905 BLD. 2 Commonwealth of Official Use Only
� E. Massachusetts Permit No. BLDE-22-000905
. 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:8/17/2021
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) 481 BUCK ISLAND RD
Owner or Tenant BUCK ISLAND VILLAGE CONDOS Telephone No.
Owner's Address C/O BOARD OF TRUSTEES,481 BUCK ISLAND RD,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: Replacement meter equipment(BUILDING#2)
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. grad. 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
Initiatine 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 ❑ Municipal ❑ 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 Siens 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 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:$80.00
�lI A (Mic1"6 key) ��
Ofkk. ceNv
``.,\ Official Use Only
Commonwealth of iuiassachusetts Permit No. 1—" 10�
j y Department of Free Services Occupancy and Fee Checked
LKev. l/u ij -
' BOARD OF FIRE PREVENTION REGULATIONS (leave bleak)
L P?UCATI u NT: FOR E>RI IIT TO IP Rll O RIA ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 Cik 12.00
r /7
(PLEASE pRLTTT.IhT Da-OR E A.LL OR�Y.fATlOAj
Date:
City or Town of: f�'`'{/W0•//( To the Ins ector Wires:
By this application the undersigned gives notice of its or her intention to perform the electrical work described below.
Location (Street e:Number): .44 7 t--'C-/C L:'44 �
Owner or Tenant T,e L9 C/S.- /�C/ 7 Y ( L er-1 G f-- ��7 t iepnone No.
Owner's Address
is this permit in cow Junction with a building per,it. ^ YesNo E (Check Appropriate Box)
Purpose of Building Utility Authorization No.
_ l�r-i S/-�1 ice%i��'�
Existing Service Amps
/ Jolts Overhead 0 Undgrd 0 Iio.o7 Meters
New Service Amps / Volts Overhead 0 Undgrd �1 No.of Meters
Number of Feeders and Ampacity ��
Location and Nature of fro used EIect c=t =�L v'� �'�
Completion of the following table maybe waived by the Inspector of Woes_
i io.of Total
No.of Recessed Luminaires Illo.of Ceil.-Susp.(Paddle)Fans ,Transformers {JA
1 rio.of'jot l�
No.of 13iminai=e Outlets s Generators =rrA_
:+Dove Tin- No.of Emergency ,ignfin
INo.of Luminaires Swimming Pool grad. n grnd. Battery Units
'No.of Receptacle }No.of Oil Earners ^t_ it%s LARP/=S }No.of Zones
Outlets �ivo.or Detection and
!No.of Switches !No.of Gas Burnersinitiating Devices
Total
ll�:a.of Air Cotid. Tons No.of�'ierting Devices
No.of RangesµI
Heat Pump \umcer Tons y{
No.of jtasteDisposers 1 Totals: '._.. ...- ._M___ 1CW Ns.aFset-t^amined
.-.---.._-- Detection/AiertingDevices
municipal
Heating Local Connection -Other
No.of Dishwashers Space/Area KW
�Q t. g KW Security Systems:=
-�_ a_i�3 Appliances -, fD
�i o.of Dryers �' No.of'Devices orEquivalent
No.f of Data csliring:
No.of Water Imo ' pp.o Heaters I SIEg5 No.of Devices or Equivalent
BHI'laS4S Telecommunications wiring:
No. �?ydromassabe Bathtubs
ko.of Motors Total 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 coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE:INSURANCE E BOND 0 OTHER 0 (Specify:)
I cer•t jtt,wider the pains and penalties of perjwy,chat the imfor7natiotry= this applications true and complete.
�, � � �rr� LIC.bl�.:v,3294}
FIRM NAME:John Brewer Electric j Ji vd.A -f t4i-'? 0- f``'
67, C� Signature �:f%.=< :.,,-""'`- LIC.NO.:A.14092
Licensee: �,�� � � : .Tel. ..
Bus. 1io -
(Ifapplicable, enter•"`e1'etnai"in the license number line) :=-j- `� rJ Alt.
�1 .gQ8-,67-Q167
�L--/ i C CU I J' fir!'1/: r !�✓.� / .7 ?,2^V'J t Tel.No'
Address: 73��Ii,.• r1=� •"-_- ! •_•_
'Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S IiN RICE WAIVER:I am aware that the Licensee does not have the liability insurance coverage normally
required by Lew.By 0.y s tore below,I hereby waive this requirement.I am the(check one) vier j owner's anent.
Owner/Agent
Signature l�j V A^-'v�- Telephone No. ( f C 1 y FER1 T FEE.
- (P
n'
s
rre x fir
•
6 ice.,.. ._..., _..._.
Si ; 1 ? t �:t•4 ;i.,
:..,e.
x
trCi
< ..
y cn
•
•
•
n-.
.y r
• a
tr i
+ ' ;C
St
.. ._.a... ........... _ ..,. ,
• v.
•
L