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Home My WebLink AboutBLDE-22-003682 Commonwealth of Official Use Only . Massachusetts Permit No. BLDE-22-003682 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:1/3/2022 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) 16 GREEN TEAL WAY Owner or Tenant WEISSBERGER EDWARD Telephone o. Owner's Address WEISSBERGER RUTH M, 16 GREEN TEAL WAY,YARMOUTH PORT, MA 026 <I •0 Is this permit in conjunction with a building permit? Yes 0 No 0 k , s : I Box) Purpose of Building Utility Authorizati' y. Existing Service Amps Volts Overhead 0 Undgrd S Noq o e New Service Amps Volts Overhead 0 Undgrd 0 rto.p et . Number of Feeders and Ampacity ,. cpf'/ ('46! Location and Nature of Proposed Electrical Work: Replace 2 HVAC systems. Completion of the following table m16e aiv , spector of Wires. .of �� Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans N Noanformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- CINo.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 2 No.of Detection and Initiating Devices No.of Air Cond. 2 Total No.of Alerting Devices No.of Ranges Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices Space/Area HeatingKW Local 0 Municipal 0 Other: No.of Dishwashers P Connection HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 kermit 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 o/mas3ach.uaetts Official Use Only R * I Permit No. 2- -5�6 ft? : 2epartment oti ire Services � BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ([Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in acccrdance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT LV INK OR TYPE ALL IVFORM4 TIO;N) Date: j,)--,D1— City or Town of: _ To the Inspector of Wires: By this application the undersign id iv es notice of is or her intention To perform the electrical work described below. Location(Street& umber pf �'`ate Owner or Tenant ( Q( We is W Telephone No. Owner's Address — Is this permit in conjunction with a building permit? Yes fl( No E (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead fl Undgrd ❑ No.of Meters New Service -- Amps_ / Volts Overhead❑ Undgrd E No.of Meters Number of Feeders and Ampacity w a� Location and Nature of Proposed Electrical Work: IV( re_ _i- .ij Completion of the following,table mar he waived hr 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 SwimmingPool Above ; In.. No.of Emergency Lighting grnd. C 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 AlertingDevices 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 0 Municipal ❑ Connection Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KWNo.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or E s uivalent No.Hvdromassag�e_13athtubs No.of Motors Total-HP Telecommunications -4' ing No.of Devices or Equivalent OTHER: Attach additional detail if-desired, or as required by the Inspector of Ffires. 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 coverage is in force,and has exhibited proof of same to the permit issuing offic,. CHECK ONE: INSURANCE -.BOND ❑ 0 obr OTHER 0 (Specify:) 14 �tw1cfsYt,✓7 6 6)-6(a' ' I certify,under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: .IA br,P,tij < _ LTC.NO.: I 0)/1 'VY Licensee: LC- Q(k) Signature LIC.NO.:,-).7c)-3g 6-- (If-applicable, enter -exert:wily the license number line.) 13us.1'el.No.._7.�76 07 -.3 Address: 103�- /YIr ch nic lid 1, nth Alt.Tel.No.: �I`a 7a7 tl,1c3y `Per M.G.L.c. 147,s. 57-61,security work requires Dekartmett of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑owner ❑owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $