HomeMy WebLinkAboutBLDE-21-006347 Commonwealth of Official Use Only
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. Massachusetts Permit No. BLDE-21-006347
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:5/4/2021
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) 32 MARINERS LN
Owner or Tenant BRESNER ARLENE I Telephone No.
Owner's Address MCKENNA LINDA S, 229 HARTFORD ST,WESTWOOD, MA 02090
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service 150 Amps Volts Overhead 0 Undgrd 0 No.of Meters
New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Upgrade service
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
g 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 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: 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
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
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Commonwealth of Massachusetts
Department of Fire Services .
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BOARD OF F RE PREVENTIO% REGULATK)NS
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
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Date: t-'( -- ,„, ../
City or Town of: ilacan. 7-- ,,„:„
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0 m ner or Tenant V\e_.-
Teiephonc No.
-------
OW ner's Address
— _Is this permit in conjun,:tion with a building permit? Yes : ' Na LL (Check tkppropriate Box)
Purpose of Building Utility Authorization No.
, _
,---, —
,Existing Service Amps 'Volts 0\erhead _ i.ndord ' ;
, t,. - No. of Meters
-----
NCI% Service _ Amps Volts Oterhead : i I_ ndgrd i No. of Meters
Number of Feeders and A irtpacit cr_r4it
I cation and Nature of Proposed Elect!. cal Work:
,No. (if Total
:No. of Recessed Luminaires No.of Ceil.-Susp,(Paddle) Fan,
-
—
.
No. of Luminaire Outlets No. of Hot Tubs Generators
; . . Alms e --, -I n_ ,---„--7CiiTiTiTriiii-:4-1YiYEZT Erg-T-1 tTiTia
No. of Luminaires istt imming I
grnd. ---: “rod. --1 ,Batters Units
No. of Receptacle Outlets ;No. 01 Oil Borrs t-lt,zr, ,A,t...-krzAls :NO, 1)14011CS
---____
N 0, of Detection and
No. of SAN itChis ,'NO. of Gni. Burners
fatal
Initiltinc Des ices
. .___.
- - -
No. of Ranges Na. of.Air C T
('and, No. of.Xler B
iing O ices
OaS
--- —
Heat Pump Number !Tons 1E:Vt. — NO-.7)1Self-rontained ------—
o. of Waste Disposers
: lotals: I 1 Detection kriin2 Devices
— Municiar r----.
!No. of Dishm,ashers :Space Area Heating kW L"c"1 L.-- Connet!tion 1--- (-)ther
_
Security Sxstems:"
No. of Dt.. ers 'Heating Appliances K.W
. No. of bet ices or Equisalent ;'N'73-:-.611.---'r, -:a ter „No. of No, of i Data Wiring:
K Vk
Heaters ; -.
• .^wgris Ballasts i No. of De.ices or Equivalent
Jelecommunicauons Wiring:
No. 1-1.t dromassagc Bathtubs !No.of Motors Total HP
: No. of Devices or Equivalent i
OTITER: _ _ ! _
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I\SURANCE COVF:RAGE: 1::::.;.'ss ..: ',..; ;':. the .,v. T. 7.o ; cr!-7.';'. ';',.•,:.r. 7e'0::-.-.I1,::: :.t.-e!.:e1;.i.,:al 't,.;):"k Ma:. kU.: int:..':,
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I coilfj., ander the j-nlin,;and penaltie., (4 peijury. that the in/Ormation on thi application d true and coniplete. '
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Licensee: C,(i..„ <!-1 Sirwiture / 1 --- 1.1C. NO.:
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Address: ', "`.‘, i ,I,j/--,, ‘'2 ! y y ,' .,(.( L..,_,,_.;"0"'C.::/----' \It. Is!. No.:____VA.,•7_,
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OWNER•S INSURANCE 'WAIVER: i :1•: '‘',:i:.2 t:.: t th: Li - 21..,,,'c•.;'.•,s ' hiN:\ :•:s.,11-o‘nL-,.: .:raoL:.-t17,1:.:rZF.----
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Owner Agent
Signature
Telephone No. LPER.11IT FEE S
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