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Home My WebLink AboutBLDE-22-000915 BLD.11 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-000915 ,.' 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:8/17/2021 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) 481 BUCK ISLAND RD Owner or Tenant BUCK ISLAND VILLAGE CONDOS Telephone N . IN—' °�'/ Owner's Address CIO BOARD OF TRUSTEES,481 BUCK ISLAND RD,WEST YARMOUTH, MA 0 h Is this permit in conjunction with a building permit? Yes 0 No 0 (Check off) - Purpose of Building Utility Authorization No. ffr (:). 1� '"i Existing Service Amps Volts Overhead 0 Undgrd 0 No.oie f�` ' ;i New Service Amps Volts Overhead 0 Undgrd 0 No.of Mete(r.V " Number of Feeders and Ampacity cf., r;_ : Location and Nature of Proposed Electrical Work: Re•lacement meterin• equlpme fi _ 4-,,ifr. ! - ,•, Completion of the following table may be waived 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 Ton 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 ❑ 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 ❑ 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: JOHN H BREWER Licensee: John H Brewer Signature LIC.NO.: 14092 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:205 CEDAR ST,W BARNSTABLE MA 026681324 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: $80.00 ,. _ Commonwealth of Massachui s PermitNQ. official Use tit t a;= , Department of Fie Services t. tru $a}... Ke�V.1i1'cy and Fee tFljeavebCiiIoed - - BOARD OF FIRE PREVENTION REGULATIONS APP ICATI I N FOR PERMIT Ti PERFORM ELECTRICAL 1."71O P, All work to be performed in accordance with the Massachusetts Electrical Code(ME 527 I2.00 Ti.R4 c FRZNTININK OR TrrE_4LL Rtv6ATION) Date: J 17 City or Town of: ., ( .0�/�c To the actor Wires: By this application the undersigned gives notice of or her inlention to perform the electrical work described below. Location(Street&Number): -144:5 / OW. C,C_/ . /C5' . b' l Owner or Tenant :-,6 Cl c f SC ' `G#/#-, tilt-Zvi G 6 C T- iephone No. Owner's Address -Is this permit in conjunction with a building permit? Yes 0 No II (Check Appropriate Box) Purpose of Building Rr=�,C/7 -v(1 Utility Authorization No. Existing Service Amps I Volts Overhead 0 Undg-d 0 No.of Meters New Service Amps / Volt Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of ProEased Elect /... �L- " r "--77 . f� C G --c- 0/ 7yf1.14; //. Completion of the following table oz4 be waived by the Inspector of Wires Mo.or °int No.of Recessed Lumbnitres 1No.of CeiL-Susp.(Paddle)Fans Transformers KVA No.of Lumina ire Ondets INo.of Hot'Nibs Generators ICVA Ab6ve bi- No.or n.mergeuc3rt�gh No.of Luminaires Swimming Pool grad. grad. II Battery Units No.of Receptacle Outlet }No.of Oil Burners FUZE ALARMS JNo.of Zones 'to.of Detection and No.of Switches No.of Gas Burners Initialing Devices 'rotas No.of Ranges No.of Air Cond. Tons No.of Alerting Device s • -Tint Pump xueatcr Tons KW tin ar3¢:saminul <' No.of Waste Disposers Totals: Dee don/Aler Devfce5 Muntcipat 1 No.of Dishwashers Space/Area Heating c Lo alII Connection Other No.of Dryers Wentin Appliances BecurigoliDevi sees or Equivalent No.of Water KW 1`O t3tr3 No.of Data Wirbw Heaters I Signs Ballasts No.of quivalent relecommuunicatonscesWirzn No.Hydromassage Bathtubs iNo.of Motors Total B' No.of Devices or Equivalent OTHER: Attach additional detail ffdesired eras requited by the Inspector of Wires. 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 Iiability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE BOND II OTHER. 9 (Specify:) I cerf67,under the pains and penalties q fpetjuiy,idun the Infoofnatt skis appilt ationislure anti conzplete. FIRM NAME:John Brewer Electric 1 at--&ice t , Cali LIC.NO.:21949 S tury,.f f• ,t.--.-,--m..,. LAC.NO.:A14092 Licensee: �'�% ,� `�� ..-� " Bus.Tel.No.: tlfapplicable enter erempl"in the license number line.) _{,.--'' Address: 73 A Ci✓ ,r jt// _ t? =>1k5 ir.bq O. ?te:1g' Al Tel.No»508-367-0167 *Per M.G.L. c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S 1i 1 CE WAIVER:I am aware that the Licensee does not have the liability insurance coverage normally required by .By ow,I hereby waive this requirement.I am the(check one) Etter 0 owner's agent Ovrnerl tZLvL SignaturereTelephone 1'da,..3�q.7 i Cr:7 PERMIT�`�:S