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Home My WebLink AboutBLDE-21-006745 Commonwealth of Official Use Only _ ,ipitm Massachusetts Permit No. BLDE-21-006745 ' . 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:5/20/2021 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 elegyical work des_ scribed belf+. ,� 0/1 Location(Street&Number) 949 GREAT ISLAND RD k hTT'(�" l/ Owner or Tena ., R Telephone No. Owner's Address G , Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A u propriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 P' )'ra • 57 New Service Amps Volts Overhead 0 Undgrd 0 No. e • Number of Feeders and Ampacity and Nature of Proposed Electrical Work: Split A/C system p47-irOD:7 Completion ofthe followingtable maybe ,'dor of Wires. dit P No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Transformers • 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 Initiating Devices No.of Ranges No.of Air Cond. 1 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 ❑ Municipal Connection 0 Other: 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: $50.00 Official Use Only Commonwealth of Maasachusels PermitNo. ��` ' ,► it Departmentof Fire Services nand Fee Checked 1;. Occupancy vv cam big} - 4,z _ BOARD OF FIRE PREVENTION REGULATIONS APPU CATIs N IF ,N PERMIT Try% PERFORM ELECTRICAL Vitt - K Ail work to be performed in accordance with the Massachusetts Electrical Code(MEC) _7 i?.00 (PIRA.4E PRINT IN_NK OR TYPE ALL 'ORl4IATIOR) Date: -,..k7 To the Insp or of es: By this application the undersigned yes notice of Ids or r intention to perform the electrical work described below. Location(Street&Number): / 7/ ), I s 6 ) �'2 Owner or Tenant J t'7 � l- 2p;�S tC / /1''J '} Telephone No. Owner's Address;s this permit in conjunction with a bttiirling permit? Yes9 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 D No.of Meters Number of Feeders and Ampacity / C Location and Nature of Proposed Elect (/l///1 t--_ W7/f " � ��/ Completion of the_following table may be waived by the Inspector of Wires. or No.of Recessed Luminaires No.of Ca.-Snap.('addle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot tubs Generators KVA A = - in- iv or mergency i,,ig.Yffc No.of Luminaires Swimming Pool grad. ❑ grnd. II Battery Units No.of Receptacle Outlets INo.of Oil Burners �ALARMS }No.of Zones iNo.orDetcction and No.of Switches No.of Gas Burners _ Initiating Devices totall No.of Ranges No.of Air Cond. Tons No.of Ale ' Devices tint romp s `t'� No.of Waste Disposers Totals: " �' Detection/- a x:; . Dailies MuniM)N ri DishwashersS ace/Area Heating KW ,Local Connection BOther No.of Ranting A lanes a cans:* No.of _.yens PP ur Devices or Equivalent No.of Water KW IR°.of No.of Data Viii.rinw Ballasts No.of Devices or Equivalent Heaters •relecammunicadonswiring: No.Hydroatassage Bathtubs No.of Motors Total' No.of Devices or Equivalent OTHER: Attach additional detail 4fderired ores required by the Inspector of Wirer Estimated Value of Electrical Work: (When required by municipal policy.) Work to Star Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for he performance coverage or its substantial wiak may i sue Then the licensee provides proof of liability_insurance including"completed operation" undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE Er BOND 9 OTHER. II (Spear) iis true and ea mete: I certlfj under die pants and penalties o.fPerytsrY Oat the aZiicillor:kl;...M�`� L�C.NO.:E't1949 FIRi NAME:John Brewer Electric ;. LIC.NO.:A14092 Licensee: 9' Signatur �'' d ,....� '""`..- /' -- Bus.Tel.No.: (Ifappticuble enter exempt"in the license number line.) Leci-SP Alt dell.No.508-367-0167 Address: 73 Mii1.L. + ;Cc f•i -J1�fi. 3'':�., //,,,L OA:,Z *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. that the Licensee does not have the liability insurance coverage normally OWNER'S WAIVER:I am aware this requirement.I am the(check one) Baer o owner's agent required by .By s' blow,Thereby waive l � ' Owner/ t Signature Telephone NoV�(D1 ) !PERMIT 1 d1 NAA3qE-111/c-Tc. e trnffi<4 , Q