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Home My WebLink AboutBLDE-22-003686 Commonwealth of Official Use Only fi_A%€` , Massachusetts Permit No. BLDE-22-003683 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:1/3/2022 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) 62 HOMESTEAD LN Owner or Tenant Tim Silva Telephone No. Owner's Address 62 HOMESTEAD LN,YARMOUTH PORT, MA 02675-1221 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 boiler&W/H. 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 rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. To No.of Alerting Devices 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water 1 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: 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 my signature below,I hereby waive this requirement.I am the(check one) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 cgiit e l " t ornmorw,eafth o l/taasach.uaetfa i Official Use Only 7 ry� Permit No, 0 ' 3lP�. ` s 2 c�'7'7epartntent a/ ire Services — i{`3 f Occupancy and Fee Checked %, .,,-- BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1;'OJ (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CAR 12.00 (PLEASE PRINT IN INK OR TYP E ALL IVF R:VI.-4 TIO.\) Date: --.- ( City or Town of: (�( (� To the Inspector o f Wires:` By this application the undersigns iv es notice of his or her intention-o erform the electrical work escribed below'. Location(Street& Number) .t- Owner or Tenant Telephone NoT (1 3 .f tiT Owner's Address _ Is this permit in conjunction with a building permit? Yes il No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / ^Volts Overhead El Undgrd No.of Meters New Service Amps / Volts Overhead T Undgrd C No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: W f rE.—bat e( cQ 4-(ai Completion of the following table may he waived by the Inspector of fires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total TransforineFs KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool AboveC.i In- ❑ No.of Emergency Lighting grnd. grnd. Battery :'nits 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 Disposers No.of Waste meat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other Connection No.of Dryers Heating Appliances KWSecurity Svstems:* No.of Devices or Equivalent No.of Water Hof No.of KW 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 Wirer. Estimated Value of Electrical Work: (When required by municipal policy.:1 Work to Start: Inspections to be requested in accordance with MEC Rule iee. 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 offic CHECK ONE: 1NSLRANCE BOND ❑ OTHER 0 (Specify:) L4alt.ov{SCawtto 8 a.6t o- --- I certify,under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: C.,li, } �'�,) LIC.NO.: I 31 C 8,4� Licensee: CY L C- .Q Signature _ LIC.NO.:r).7—39 L: (If applicable, enter "exem t"i the license number line.) Bus.Tel.No.:_, 2_2_S,O7a-3 Address: 103,dc WI t ABch nr, \n i, I p Alt.Tel.No.: • b 77 tgc)-y *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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: ......... ...........-.....