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Home My WebLink AboutBLDE-22-007202 Commonwealth of Official Use Only -ffi, ,,[ Massachusetts Permit No. BLDE-22-007202 C 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:6/14/2022 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) 130 BAXTER AVE Owner or Tenant BECOTTE MICHAEL J TRS Telephone No. Owner's Address GIFFORD SUSAN M TRS, 136 HILLSIDE RD, NORTH ANDOVER, MA 01845 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 /of Meters New Service Amps Volts Overhead 0 Undgrd 0 mil. 7. Mkt• s w Number of Feeders and Ampacity r / . n Location and Nature of Proposed Electrical Work: Replacement boiler&water heater. ....0:p;, •)' Completion of the following table may l / ' b, s r of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of otal Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators j^)'VA 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 1 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 No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water 1 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 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 of 41liz,13ackdeit4 Official Use Only + 2epartment of,fire .ervices Permit No,r/� �l�� Occupancy and Fee Checked � BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 ( cave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in acccrdance with the Massachusetts Electrical Code MEC),5?7 CM 12.00 (PLEASE PRINT IN INK OR TY E,AL INFO R ATION) Date: j `^ ! �. ..Y fl �rof Cityor Town of: To the Inspector Wires: By this application the undersigns give nonce of his or her intenti+ . perform the electrical- ork described below. Location(Street&Number) 1 1-et 43 (Q i i .. Owner or Tenant taiaLQ Telephone No.g76 a6 377a. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No C (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service —__ Amps / Volts Overhead 0 Undgrd C No.of Meters Number of Feeders and Ampacity _Location and Nature of Proposed Electrical Work: j`f'e �t __N wccte , -- 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 KVVAA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool 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 l'No.of Detect' 1 a d _ Initialing Devices No.of Ranges No.of Air Cond. Val !No.of AlertingDevices Tuns No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Contained Totals: !Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW i L o c a 1❑ CoMunicipannectionl ❑ Other No.of Dryers Heating Appliances KW Securtty.vstems: No,of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters ins Ballasts No.of Devices or E uivalent 'Telecommunications irmg. No.TIy°dromassage ratfitO 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: Inspections to be requested in accordance with MEC Rule IC,. 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 o 'erage is in force, and has exhibited proof of same to the pe it issuing office. CHECK ONE: INSURANCE }kJ BOND 0 OTHER 0 (Specify:) .ra bt(( / (6Ersc 9 8-3 ad-) I certify,under the pains and 'ena 'es of perjury,that the information on this applicat is true and cot>►ittplete, FIRM NAME:, g,0 1,(i( G � z LIC.NO.: 1 3) ( - Licensee: CC�� j L �, G6 r. Signature LIC.NO.:c �,.34 (If applicable,enter ' xemp " e 1. a is number line.' 2 �� r Bus.Tel.No.: ij 7'�4tii o 7a-� Address: � Gil- tl Alt.Tel.No.: 7'2;7 44)- *Per M.G.L.c. 147,s. 57-61,security work requir s Department 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No.� PERMIT FEE: $