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Home My WebLink AboutBLDE-22-001029 Commonwealth of Official Use Only fa% Massachusetts Permit No. BLDE-22-001029 • 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:8/24/2021 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) 109 LAKEFIELD RD Owner or Tenant MUSCATO BRYAN R Telephone No. Owner's Address MUSCATO SHARON L, 109 LAKEFIELD RD, SOUTH YARMOUTH, MA 02664-2962 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: Wire NC system&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 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 0 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: 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 ' .. Commonwealth of Massachusetts i Official 1. Oiti. Department of Fire Services Permit ?�-''mow Occupancy and Fee Checked a' BOARD OF FIRE PREVENTION REGULATIONS ER v. 1 0,�J ri4ace blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Aii work k co he performed in ae o dance ,%itb ray Nlassachu,eits Electrical Code(ME{).jr C\rR 12.00 (PLEASE PRINT IN INK OR TYPE ALL I.\f'DI.1 A 770.\) Date: City or Town of: By this application or the tindr tiQrrno To the inspector of t�i`ires: lied �'es nc Lice Ibis or / er it to Lion to rfor;n the electr;caal o,k described belov.. Location (Street& Num er) Owner or Tenant 1<C Q0 ,Ca- Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes FT No ri Purpose of Building (Check :appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead !1 t'ndgrd , No.of Meters Ness Service .Amps ; Volts Overhead f Lndgrd ri No. of Meters ~umber :' ::' Feed d Armpacity -- Location nd of Proposed Electrical Work: --- (— Completion f tilt!1tilto;.iri table may be c a 1;: nc�ct No. of Recessed Luminaires fit'If o.of Ceil.-Susp. (Paddle) Fans So. of Total ``" � - Transformers KVA No. of Luminaire Outlets No.of Hot Tubs --- �Generators KVA No. of Luminaires 1Swimming Pool o bone In- 1No.of Emergency Lighting „rnd• Q �7rnd• !Battery_.. Units 1 No.of Receptacle Outlets No.of Oil Burners FIRE :sl..tr2MS \o. of Zones No. of Switches No.of Gas Burners Ao.o Detectron and No. of Ranges 1 Initiatin J Devices _ No.of Air Cond. Tons Nei of alerting Devices ' \o. of Waste Disposers heat umI} Number ens tt' Totals: \o.o e Contained No. of Dishwashers 'Detection/Alertirto Devices Space:Area Heating KW Local 1�C unlecti o.of Dryers C.onncction C Other cleating.Appliances KW -¢ -- __. .� KiV ;Security Systems:• \o. of tt'atcr No. ___._, No.of Devices or E uivalent Beaters KW \o. of Data iring: Signs Ballasts - -----__No.of Devices or Equival•ent No. Hydromassage Bathtubs Telecommunications tirnn �o.of 1lotors "Total HP g OTHER: _ __o.of Devices or Equivalent _ r m g ,��l � ", _d I, - l;icr ec4. air !C-f2e=EIII:c/ncpF yr Jj df.r e,.EsIITatCd Value of L1Lc I1c2i Work: (When required by municipal policy.)Work to Start: Inspections to be requested in accordance with NIEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless:wais.cd by the owner. no permit for the 7)erformance of electrical l' The licensee proA ides proof(�_t ildh !r �� r�)llruq�e 'L Citltirilt'-completed C<m)leted o work miv issueei unless undersigned CLr[nfICi alit such eC'V erti�ie ,s in � S I operation-coverage substantial j � force. till as exhibited p,oof of same to the er i _ssuin,1r3a1 equivalent. The CHECK.C K OV"I-:: !\SLR \\CF: n permit is,uint I _ F3O\D a OTtiEFZ office. eerlifi•, under the pains andpenalties o . � f,Sp`c:E'��:r ;,�'�.G`r� �r?�4�1�t�n� � i'f'f,� ��at-f I`Per7ury, that the injh i�rution on this application t. true and complete. L I•tR�r` aNIer h AA--) t/er Licensee: !I nsee(INC. r. Signature / _---_—_ -- Addradds Address: f ,y ,r a r n r77I, j' y..,., LIC. NO.: a7�35 �.:- ss System( r K1 '` 1, 93 Bus. Tel. No.: T�j Contractor License require for this work i applicable, enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does ref�; alt. Tel. No.: S �'7 O\ \E by law. By my signature be!ot�I1 i uw . the liability i required lOwner/Agent hereby waive this requrl'ement. I and the . rlslFrc.L e COt Cra L n is a' e- Signature (check'one? " 1 ati�raer Telephone No. PERMIT ca«ncr'a aJent. PEn:bl_____ __