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Home My WebLink AboutBLDE-21-004551 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-004551 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:2/11/2021 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) 1079&1083 GREAT ISLAND RI Owner or Tenant NOLEN ELIOT C Telephone No. Owner's Address 1120 5TH AVE, NEW YORK, NY 10128-0144 Is this permit in conjunction with a building permit? Yes 0 No 0 (Che . Appropriate Box) Purpose of Building Utility Authorization No. Q Existing Service Amps Volts Overhead 0 Undgrd p 4 eters New Service Amps Volts Overhead 0 Undgrd .4 , Pact r Number of Feeders and Ampacity �� Location and Nature of Proposed Electrical Work: Rewire well house in basement. J O j i) Completion of the followingtable mo t Insp ector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of O Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above nd. ❑ II,.nd ❑ No.of Emergency Lighting 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No No.of Devices or Equivalent HeatersWater KW No.of No.of Data Wiring: Siens 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.) Address:205 CEDAR ST, W BARNSTABLE MA 026681324 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 signature below,I hereby waive this requirement.I am the(check one)) 0 owner ❑ owner's agent.Owner/Agent Signature Telephone No. 'PERMIT FEE: $50.00 I Official Use Only Commonwealth of Massachusetts Permit No. ( 2k 55 1 t __ Department of Fire Services Occupancy and Fee Checked «' -, BOARD OF FIRE PREVENTION REGULATIONS �xev. 11U�j (leave blank) _._. AF*PLICATION FOR PERMIT TO PE F.RM ELECT '1 KCAL W{J RK All work to be performed in accordance with the Massachusetts Electrical Code ),5527 MR 1?00 (PLEASE PRINT ININli OR TYPE LIr�FORMATIO.'O Date: ' I d/ City or Town of: /s1 c ,j�� To the Inspector f Wires: By this application the undersigned ves notice of his or her intention to perform the electrical work described below. Location(Street&Number): L Owner or Tenant 4, (() telephone No, Owner's Address Is this permit in conjunction with a building permit_ Yes 0 No Ee (Check Appropriate Box) Purpose of Building R(- i<� ",eNi(- Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd D No.of Meters New Service Amps / Volts Overhead 0 Undgrd El No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Elect tilt//f? A/fc.I,v - i fir (,c% , i a''-2 Completion of the following table may be waived ly the Inspector of Wires. No.of Tout No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Transformers KVA No.of Luniinaire Outlets No.of Hot Tubs Generators KVA Above in- No.DTEme gency Lighdng No.of Luminaires Swimming Pool grad. " grnd. " Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS }No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices `— Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices Heat Pump ilium er Tans ttw DLL arSetf-Cssmi�tl Na.of Waste Disposers Totals: ' —I- — Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local"Connection "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 Telecommunications Winf: No.Hydromassage Bathtubs INo.of Motors Total DP No.of Devices or Equivalent . OTHER: Attach additional detail if desired or as required by the inspector of Wires_ Estimated Value of Electrical Work: ({Wien 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 El BOND 0 OTHER ❑ (Specify:) I certib,under the pants and penalties ofperjury,t tat the h format" t this applicrttt is true and complete. FIRM NAME:John Brewer Electric '; { g � ^4te a, Urell LIC.NO.:I+. 1949 Licensee: t'.�i �� Signature .- ., ..1,-,-,-- -- ..- LIC.NO.A34092 Bus.TeL tlfappiicable. enter 'exempt"in the license number line.) ��---- j �, Alt.TeL o.308 36?-olb7 Address: 73 tvii1.r'.M ( ; .414�rrc! f/l -� AA O1. ts' *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.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) Elmer 0 owner's agent. Owner/Agent Telephone No. I'�ERBIIT FEE:Signature d 14