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Home My WebLink AboutBLDE-22-000761 Commonwealth of Official Use Only :., Massachusetts Permit No. BLDE 22 000761 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:8/10/2021 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) 583D FOREST RD UNIT 4 , � °� � Owner or Tenant BAKER MEREDITH R TR Telephone fit e ephone No. ;--•.�, Owner's Address THE BAKER FAMILY TRUST, 110 VALHALLA DR, 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install conduit for communications cable from pole to building.(C.C.ALARMS,204 Old Townhouse Rd.) 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 Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 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: $80.00 v (2___ e ( u (-zt r-, Commonwealth of Massachusetts � _ � Official Use Only 4. Department of Fire ServicesPermit No �2-- l (� ,_, a h BOARD OFFiRE F�REVEI`dl IOU REGULATIONS �[ReOcc9pan]y and Fee Checked (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(4EC) 527 C R 12.00 (PLEASE PRINT LV INK OR T/P AL INFO AT1OVJ Date: g City or Town of: a � a To the Ins ect r of Wires: By this application the undersigned ivies notice o s r her' tendon t erform the ele 'c• w rk e ribed b low. Location (Street&Nu ben) Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes [ No l i (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service - Amps / Volts Overhead Undgrd I ] No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ( �"' -- r mit- p r _ Completion o rt. it owin'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 m � FIRE ALARMS [No. of Zones No.of Switches No.of Gas Burners iNo. of Detectionnitiating and I Devices No. of Ranges No.of Air Cond. Total Tons kNo.of Alerting Devices No.of Waste Disposers Heat Pump 1 Number I Tons KW [No.of Self-Contained Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW iLocal❑ Municipal No.of D Connection Other ryers Heating Appliances ��ecurity` v stems:* No.of DryeWater K`ti No.of of Devices or Equivalent Heaters ICV� 0 of Dataa Wiring: Signs Ballasts No.of Devices or Equivalent No. Hy'dromassage Bathtubs - !o.of Motors Total HP TelecommuntcahonsWfiring; UTIIER: No.of Devices or E uivalent Attach eu otal demit if desired, or as required hr the Inspector of II tees. required by municipal policy.) Work to Stan: 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 office. CHECK ONE: INSURANCE [ BOND [] OTHER I certiff•,under the pains and penalties oinformation this application at i t true and c e.( �� FIRM NAME: '0�r7 f perjury,that the information on lt i true c o lete. Licensee: �C � LIC.NO.: j 3f 1v _ (ffa applicable ent Signature LIC.NO.: a7e�3 PP enrpt in tJt lie in ether!ut Address: .) /� Bus.Tel.No.: 7�j 3 *Security System Contractor License requires for this work i applicable,enter the license numbAlt.Tel,er here:No.. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hare the liability insurance coverage normally 7 required by law. By my signature below,I hereby waive this requirement. I am the(check one) owner owner's anent. Owner/Agent Signature Telephone No. PERMIT FEE: $