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HomeMy WebLinkAboutBLDE-22-000908 BLD. 4 Commonwealth of Official Use Only -E. Massachusetts Permit No. BLDE-22-000908 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:8/17/2021 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 electrical work described below. Location(Street&Number) 481 BUCK ISLAND RD Owner or Tenant BUCK ISLAND VILLAGE CONDOS Telephone No. Owner's Address C/O BOARD OF TRUSTEES,481 BUCK ISLAND RD,WEST YARMOUTH, MA 02673 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 ❑ 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 meterin• equi•m 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 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. 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water 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 (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 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: $80.00 tala q501a Commonwealth of Massachusetts Official use Permirl�Io. (� �, Dparlrnenof Fire Services Fr € Occupancyand Fee Checked _ :..: [Key_. I ItF1 J -•- '-'�_ BOARD OF FIRE PREVENTION REGULATIONS (leave blank) APPLICATII N FOR PE 7 i'Si if TO PERF0 F, , ELECTRICAL V,% 4)RliC All work to be performed in accordance with the MassachusettsEIectrical Code(ME 527 1100 (n:RARE PRATT rN INK OR E ALL orMATIoA) Date: / 17 r City or Town of: -' 6 f.4//� To the ector tames: By this application the undersigned gives notice of I{ or her ii ention to perform the electrical work described below. Location(Street&Number): - /�!4 V LC L f Owner or Tenant 343(1 C f S• :Asz , -j V*1 G 5-' (2 /.Iephone No. €wner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building /c--=�S,-4,-- „,y,( Utility Authorization No. Existing Service Amps / Volts Overhead 0I 11 Undgrd 0 No.of Meters New Service Amps / !!Volts Overhead Undgrd 0 No.of Meters Number of Feeders and Ampacity � � Location and Nature of Pro osed Elect A)�"�`rLa� C.�c�/'{�r'��t`�! �t�- - C U/ Lz7li'1J( LA Completion of the following.table may be waived by the Inspector of Wires. of Total No.of Recessed Lumina-es INo.of eel-Snap.(Paddle)Fans Transformers KVA No.of Luminaire Cutlets No.of Hottitias Generators KVA A36ve hi- No..d ergency Wining No.of Luminaires Swimming Pool grad. grad. Li Battery Units No.of Receptacle Outlet No.of Oil Burners FUZE AL ARKS 'No.of Zones vo.of Detection and No..of Switches No.of Gas Burners Imo' g Devices Tout No.of_Sara 'No.of Air Cond. Tons No.of Alerting Devices - neatPnmp Nut Tans jRv corif Amin . No.of Waste Disposers i otals;1 1 1 D.,=fectiotrlAiett: Municipal No.of Dishwashers Space/Area Reathig KW Local"'Connection El Other • No.of'Dryers a�Appliances• �ofDevices or Equivalent No.of Water gam/ No.of No.of Data Wirong: ,eatersBallasts No.of Devicesor Equivalent =' Signs `relecommunicaWoas Wiring: No.hydromasssage Bathtubs iNo.of Motors Totals No.of Devices or Equivalent: OTHER: d the ara tYd eluach additional detail(([desired ours require b3 inspect ,f Estimated Value of Electrical Work•. (When 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 covevige is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE - BOND 9 OTHER. (Specify:) this app t`rn rs awe and complete I semi?,under the pains and penalties©fpeifriy, _th ��;;;;``,,�� W FIRM NAME:John Brewer Electric -. E ivt 's Et4.6 . ` . . 1 LIC.NOD.E21949 ,l` `� ,,,� LKC.NO.:A14092 Licensee: �` ,f �#•'�Cfr Signature r »l�r..�. --'"'�.. .r Bus.Tel.No.: t!�'appficobt� enter exempt"in the license.�rrrrrber line} Y.._-''f ! li�u'�e1.l�D:50&3b7-i1t67 Address: 73 tliAL.fal j)2o �." - / .S GYM.'OR(t". *per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S IN _NCE WAIVER:I am aware that the Licensee does not hove the liability insurance coverage normally requires by By s' below,I hereby waive this requirement.I am the(check one) Ever 0 owner's agent Owner/ t •� Signature Telephone No tD✓ (- ) PST PEE:1 C1/4 ',E-14 egaV�i , e