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Home My WebLink AboutBLDE-21-003614 «` Commonwealth of official use only 4.,. 4Nil Massachusetts Permit No. BLDE-21-003614 ,`"'" 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:12/31/2020 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) 115 CHIPPING GREEN CIR Owner or Tenant CARTER AVIS E Owner's Address 115 CHIPPING GREEN CIR, SOUTH YARMOUTH, MA 02664 Telephone No. Is this permit in conjunction with a building permit? Yes 0 No 0 Purpose of Building (Check Appropriate Box) Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 gNo.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 new heat. 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 i in grnd. grnd. El Battery Units y ` No.of Receptacle Outlets No.of Oil Burners ` ' FIRE ALARM I,No.of Zones-, ; No.of Switches No.of Gas Burners No.of Detect' n id 4 Initiating D ice - ' , '`� No.of Ranges No.of Air Cond. Total ✓ / Tons No.of Alerting Devices (® ,J No.of Waste Disposers Heat Pump I Number f Tons I KW No.of Self-Contaiite�d �`� // Totals: l Detection/Alerting DevicesY No.of Dishwashers Space/Area Heating KW Municipal ' �' Local 0 Connection 0" Other:I' No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devics or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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 ❑ :) I certify,under the pains and penalties o.Tperjury,that the information on this application istrue and complete. FIRM NAME: Eric W Drew Licensee: Eric W Drew Signature Tel. NO.: 13118 (If applicable,enter"exempt"in the license number line.) Address: 103 MID TECH DR,UNIT A,W YARMOUTH MA 026732588 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But 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 1 ' i� /' 9/ i it -- gtz!, ot12u ' C..ommonweanit o/1/ * r �aasacirccseffa Utlicia!Use On1: - �� 21eparfinenf of 5 re SereiceJ ! Permit'�o. �/`� �� ( LA- . "'A.. . BOARD OF FIRE PREVENTION REGULATIONS ` Occupancy and Fee Checked [Rev. �7].. (lea%e blank) __�� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL ! } All Work to be performed in accordance with the Massachusetts Electrical Cod C (MEC).527 „KM`WORK (PLEASE PRINT IN'INK OR TYPE ALL LVFOR.tf TIO\'j Date: City or Town of: TBy this application the undersig ed Div s nonce of his or her intent io to e F�nnit cede trical � � described Location(Street&Number) tsc rtbed below. Owner or Tenant Dr Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes ��_— Purpose of Building Q No C (Check Appropriate Box) Utility Authorization No,�_Existing Service Amps / #olts -- Overhead Q indgrd No.of Meters Nev,... vice,. Amps / Volts Number of Feeders and Ampacitti Overhead Undgrd No.of Meters Location and Nature of Proposed Electrical Work: Cum letiorr of the/ollottin'table owl.he+,awed ht the Les)ettvr of Wire.,. No.of:::::::: :7, No.of t No.of Hnt Pub GeneratorsNo. of �� nru- . o,o mergence tg mg Swimming Pool ��. of eptac:ie OuHers rod. d. Li Battery Units - - N off3ll Burners - No.of Switches ;FIRE ALARMS No.of Zones ones No.of Gas Burners : a.o etectton an No. of Ranges Initiatin Devices 1 No.of Air Cond. otal 'Ions No.of Alerting Devices i No.of Waste Disposers 'eat `ump um+er ons Totals: o .e - ontaine -------I "—__ - No,of Dishwashers 'lletectioniAlertin. Devices -__ Space/Area Heating Ktia' Locai❑ unicipa No. of Drtiers Heating Appliances Connection ❑ Other i; pp empty ti stems: • o, o rater Kw Heaters K«' #o.o No.of Devices or Ec uivalent o, o Data Wiring: Si'ns Ballasts No.of Devices or Ec uivalent No. Hydromassage Bathtubs No.of MotorsTotal HP elecommunica ons -"ring: OTHER: No.of Deices or E uivalent stit?aaied Value of Electrical Work: -detach nciclitional detail t cli�,�irrci,ours rei/ui,t/hr the l)1.tpcele�r sr;'{�'1i•c:; Work to Start: (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10. and upon completion. INSURANCE CO%'ERAGE: Unless waived by the owner.no permit for theperformance ofelectrical the licensee provides proof of liability insurance including-completed operation coverage or its substantial equivalent. The work rna�� issue unless undersigned certifies that such t;o}�erage is in force,and has exhibited proof of same to the per it issui fig office. �� Ct-tEc.x ONE: tNsuR:v�;Ctr t3o\ij O 07 HER D (S ecif / t certr , under the pains and penalties o r'ur> (Specify.)Y �✓5 L QrYon 1Qnd 1 i le e. FIRM NAME: fP .J,th t the information on this application rs true and sample e. i Licensee: �i L� L�.� �� I.IC.ti0.: (//applic•ablc,enter Signature �__ -exempt-in the 1 Tense',umbel-line.) --_ LIC.NO. �C7L� Address: "Per M.G.L.c. 147.s. 57-61,security work require Department of Public Safety."S'"License: Lic.Bus,Tel. No.: (� .�_� �7 c�3 Alt.Tel.No.: • - 7 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hare the liability insurance coverage normally required by law. By my signature below.I hereby waive this requirement. I am the(check one) o+rt ro Owner/Agent Signature owner's a ettt. Telephone No. PERMIT FEE: