HomeMy WebLinkAboutBLDE-22-001794 • or /
1 Commonwealth of Official Use Only
1-#. � Massachusetts Permit No. BLDE-22-001794
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:9/29/2021
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) 728 ROUTE 28
Owner or Tenant PIRATES COVE EAST INC Telephone No.
Owner's Address 728 ROUTE 28, SOUTH YARMOUTH, MA 02664-5158
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: Wiring for septic system&wiring for remodel of bathroom.
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
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/Alertine 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 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 ❑ BOND ❑ OTHER ❑ (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:$200.00
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BC.)ARD OF FIRE _
APPLICATION
AON FOR
PERMIT TO PERFORM ELECTRICAL
AL WORK
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� ` Date:
l.ir�aticrn ., ; ,;
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(Street& - 4 nhe ri i
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or T'rnartt n
(h.ncr's Address
'I elephone Nu.
Ic this permit in conjunction with a permit?
errnit.+ r
Purpose of Building No _� (Check c!..-�pprc(pr sate• BoRj
Service
Existing.
} --
ttiiit} autht,rt.atfc;rr No.
Amps ult
irt{,t L}
Nett Service ice _ } ln, of tilers r.
1 ntp� _ ohs r ()vet-Iliad E ntt,rd
Number of Feeders: and:+�rzt1>acity _ R(?• o9 sever,
Location and nature or Prc:pus.t� Electrical 11 atria: ��
a cvrre se ._. `c IA
S
}\u. of Recessed. t.urtarnaires
\u. of C k3i,-,t,.p (Paddle) l• t ik
;\ ofl
Total
NO. of"1 untlnai,r ()inlets r anstuu(tcE
:No. of Hot 7 uo;
;Nu. ail } trntifr Sit k �_ . < s
' t.rrllritrn,� limo 111( k ._ lrl R tr�� tvtr
' <i ufTrnkr<Enc�I`r?Er
urnd tur
xr ocl. '',Battery
,t rtv ctprrcta't>tacre[o rtlis
Yfr, of Oil 13ur tear.
r!{th
fat of `sivrfClh� I RKZI' \(I, of brat.
of(iav Burners
!Nil, {
L(I of Ranges
tntt.tttrnt'illtt tr e.
Coml. 'loud
l-o . 'Ro rf ,Rls t tt I l)t.rte,
\u of Waste Disposersl Totals:Etlkai Yuftt} `\tit�iiitr i'hs,n
hit it, tat Skit E ont tRnccl
_
f o of f)ishv„t�i e3.
l)a tektr:sn e.lcr tint Der ice.!
_.-.__. l.Iits R! r }la rtEtir 1:11 tt ,1 untetptl ----. ,„
.t -
r\a oft)¢.aas C trtrne taun ft,atin .app.. aa.a•, t (t t rn-
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rle ter, Kt‘ '',No. No. Of
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B til:t.,, Data �!urnt r ( ttra tief
s{ rt
\( 11)tlroina,.,t�,a Bathtubs o of t)vtatt, ( t 1 ; utti akin.
.r:,of Flow: '`
t vti+1 }{1' Telecommunications �R;ring:
!t i Ili R.
NO.of Del iQ , O Liltlrtalellt
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l crj.+tj�'. wider the - r i , ,, ` r;;
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