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Home My WebLink AboutBLDE-22-000332 s. or Commonwealth of Official Use Only bat\ E. Massachusetts Permit No. BLDE-22-000332 li 'l 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:7/20/2021 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) 35 BRIAR CIR Owner or Tenant Marie Barth Telephone No. Owner's Address 35 BRIAR CIR, SOUTH YARMOUTH, MA 02664 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: Septic pump&alarm. 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 1 No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts Data Wiring: Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 1 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: EDWARD L MERRY Licensee: Edward L Merry Signature LIC.NO.: 17137 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 15 CHECKERBERRY LN,W YARMOUTH MA 026733636 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 I s 7 2Q(Z-( 0 R E e - V E D Mtts Official Use Only * -i \ €t. Departmentommonwealth ofof Fire Sassachuseervices r 1 Permit No. 22-0 35� :1 �7A 0T: R OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked P BUILD!r ►^". PARMENT Permit By: (leave blank) ION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 1.\d4PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7/19/2021 City or Town of Yarmouth By this application the undersigned gives notice of his or her intention to perform he electrical work described below. Location(Street&Number 35 Briar Circle Owner or Tenant Marie Barth Telephone No. 508-246-6350 Owner's Address same Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building Existing Service 200 Utility Authorization No. Amps 120/240 Volts Overhead 0 Undgrd 0 No.of Meters 1 New Service Amps Volts Overhead 0 Undgrd Number of Feeders and Ampacity g ❑ No.of Meters Location and Nature of Proposed Electrical Work: Install new circuit to existing service for septic pump and control panel. Com.letion o the ollowin_• table ma be waived b the Inspector o Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total za Transformers KVA No.of Hot Tubs No.of Luminaires Generators KVA Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting :rnd. I rnd. Batte 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 No.of Ranges Initiati n Devices No.of Air Cond. Total Heat Pump Tons No.of Alerting Devices Number Tons 1 p No.of Self-Contained No.of Waste Disposers Totals: No.of Dishwashers j Detection/Alertin l Devices Space/Area Heating KW Local ❑ Municipal No.of Dryers Connection ❑ Other J Heating Appliances KW Security Systems: No.of Water No.of Devices or E I uivalent Heaters ' No.of No.of Si ns Data Wiring: No.Hydro massage Bathtubs Ballasts No.of Devices or E.uivalent No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E 1 uivalent Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: $900 Work to Start 7-19-2021 (When required by municipal policy.)P P° Y) nspections o be requested in accordance with INSURANCE COVERAGE: Unless waived by the owner, no permit forth the e ofECelectrical le 10, upon completion. proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifie force,and has exhibited proof of same to the permit issuing office. work may issue unless the licensee provides CHECK ONE: INSURANCE s that such coverage is in ® BOND 0 OTHER 0 (Specify:)P ty') GENERAL COMP LIABILITY I Cemly,under the pains and penalties ofperjury,that the information 06/2ratio FIRM NAME: I �►wtion on this application is true and complete (Expiration Date) Licensee: , LIC.NO.:AMR__ (I,c applicable,enter exempt"in the license number line.) Signature Ad r s: LIC.NO.: 35745E 1 Check r e lane W s Yarmouth M Bus.TeL No.: sog-221-4335 *Per M.G.L.c. 147 s.57-61 securi work re uires De 0267 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does t not have c Safe `the liability License:here: Alt.Tel.No.: my signature below,I hereby waive this requirement. I am the(check one)0Lic.No. Owner/Agent insurance coverage normally required by law. By Signature owner 0owner's a:ent. Telephone No. PERMIT FEE:$ C ' -1