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Home My WebLink AboutBLDE-23-000659 F' Commonwealth of r Official Use Only FL `, \ Massachusetts Permit No. BLDE-23-000659 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:8/9/2022 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) 135 BLUE ROCK RD Owner or Tenant BARKER ROLAND JR TR Telephone No. Owner's Address ROLAND BARKER JR LVG TRUST, 135 BLUE ROCK RD, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 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 g bovend. ❑ IInnd ❑ No.of Emergency Lighting r 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. Tot No.of Alerting Devices Toni Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 Water No.of Devices or Equivalent KW No.of No.of Ballasts Data Wiring: Heaters Signs 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 I certify,under the pains and penalties o.fperjury,that the information on this application is true and complete. FIRM NAME: Eric W Drew Licensee: Eric W Drew Signature Tel. NO.: 13118 (If applicable,enter"exempt"in the license number line.) Address: 103 MID TECH DR,UNIT A,W YARMOUTH MA 026732588 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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 - -, Cnmmotuuea[th ofi ��Iaaiachuaettl Official C'se Only --, 1 }� it art 1�,. - p meet a �ire Services Permit No. ' :, BOARD OF FIRE PREVENTION REGULATIONS [Rev. Irc,7� _____ I (leave blank) i All work to be PERMIT TO PERFORM ELECTRICAL � performed in acccrdance with the Massachusetts Electrical Code(MEC •52 (PLEASE PRINT I. �INK OR TYPE ALL I\ ' V1.4TIOlj WORK City or Town of: ?CMR 12.00 Dater By this application th_ undersiane iv es notice of 's or her int To the Inspector ofo kWires:cr Location(Street 8`lumber) °n'o erto ! t lectrical work e tribe claw. Owner or Tenant _ V Owner's Address Is this permit in conjunction with a i�, TE`lepho► o Purpose Building g permit? Yes ❑ Non !-�!_ LJ (Check Appropriate BoX)Existing Service/OQ Utility Authorization •'r'o. Amps / Volts New---- S-- ce Overhead' Undgrd — g ❑ So• of titers t Number of Fee Amps 1 olts Overhead ----._ Feeders and Ampacity L'ndgrd [� No.of Meters t'Location and nature of Proposed Electrical`Fork: �0.of Recessed.LuminairesCo"''let`°„of the lvllowin. table mar 1:t ;;-1 No. of Ceil.-Susp.(Paddle) Fans --- ed br.the lnyctot•oI I6'ires. No.of Luminaire Outlets o.o otal No.of Hot Tubs orners KVA No.of Luminaires Generators KVA Swimming Pool Ab°ve n- No.of Receptacle Outlets 'red. ❑ !red. ❑ °'o mergence tg tng No,of OfI Burners ;Battery units No. of Switches ------__�____ _________ FIRE ALARMS No,of"Zones No.of Gas Burners No.o Detection and Na.of Ranges Initiation Devices No.of Air Cond. ' `eta No.of Waste Disposers eat 'um Tons - :'No.of Alerting Devices P !ap?!er oils.. No.of Dishwashers Totals: o.o e - ontatne Detection/Alertin Devices --,_ _ __ Space/Area Heating KW No.of Dryers Local[] umctpal HeatingAppliancesConnection ❑ Other t No.o Water K��' ecuratr 'systems: Heaters Kai' . 'o.Ci No.of No.of Devices or E uivalent No.Hydromassage BathtubsSi ns Ballasts Data Wiring: No.of Motors No.of Devices or E uivalent OTHER: Total HP elecomrnunications i'iring: ---- No.of Devices or E uivalent �� Attach arlrlitrona!cictail if desired. or as r equired br the/nspec for of{f Tres. Estimated Value of Electrical Work: Work to Stan: —____ _ (When required by municipal policy.) ----_ _________^ Inspections to be requested in accordance with MEC Rule 10. and upon completion. INSERANCF, COVI_�CE: unless waived by the owner. no INSURANCE licensee provides proof of liability insurance including for the undersigned certifies d proof such coverage s in insurance in,and has complete i�op rati n-cover e of isel subical tial e may lent. unless e hibitedd roof ofsa e to thee er its substantial equivalent The CHECKf. ONE: I?�'SLRANCE A r same to the I p ,BOND [0 OTHERPermit issuing offic .fy,under the ales and penalties o 0 (Specify:) L(0.f w�G1rS ,/� FIRM NAME: .fp try,that the information on this application is true and complete. Licensee:;�` ac.. -e tljapplic•able,enter "event 1',i the license number lir1G• Signature LIC.NO.:� ' Address: '--- _ LIC.NO.: 7� cj L `Per VI.G.L.c 147, s.57-61, security work requires De artm t of Public Safet Bus.Tel.No,; OWNER'S INSURANCE WAIVER: I am aware that the Licensee does notAlt. TeL No,: d 7 i required byg S"License: Lin. No. y By my signature below,I hereby waive this requirement. I am the(cheek one's Owner/Agent law, hare the liability insurance coverageon m ally Signature ��_ Telephone No.__________ ❑owner owner's anent• PERMIT FEE: