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Home My WebLink AboutBLDE-23-0009658 Official Use Only . Commonwealth of Massachusetts Permit No. BLDE-23-000658 ' »" 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:8/9/2022 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) 27 RUNE STONE RD ` Owner or Tenant PETRONE LORRAINE R Telephone No. Owner's Address 27 RUNESTONE RD, SOUTH YARMOUTH, MA 02664-1324 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. • Existing Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ In-grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices Local 0 Municipal 0 Other: No.of Dishwashers Space/Area Heating KWConnection Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs 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 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 LIC.NO.: 13118 Licensee: Eric W Drew Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address: 103 MID TECH DR,UNIT A,W YARMOUTH MA 026732588 *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 'PERMIT FEE: $50.00 I Signature Telephone No. L raj / CommonweainZ of//lamaclweit3 r? - Official Use Only <LJepa,lntenf nl }ipg„Services-r rt Permit No. �r �C BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (lea — APPLICATION FOR PERMIT TO PERFORM ELECT`'eRICICblank)All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 CMR A 0 WORK (PLEASE PRINT IN INK OR TYPE AL I,VFO.?) 4 TIO.Vj Date: City or Town of: r To the Inspector of Wires: By this application the undersigned fives notic f his or er'mention o pe - the elect 'cal w rk des ribed below. Location(Street& N ber) Owner or Tenant t Owner's Address Telephone No. E 737 aS b i Is this permit in conjunction with a building permit? Yes ❑ No E (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd 0 No.of Meters New Service Amps / Volts Overheat! Number of Feeders and Ampacity ❑ Undgrd C No.of Meters Location and Nature of Proposed Electrical Work: Ap vi,c,Q Completion of the following,table may be waived by the Inspector o1 1rises. 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- 1-1 No.of Emergency Lighting grnd. grad. Battery Lints No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection an Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers 'feat Pump Number Tons KW ,No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal ❑ Connection ❑ Other No.of Dryers Heating AppliancesSecurtyt `systems:* KW No.of Ibevices or Equivalent No.of Water "War No.of KW Heaters Data Wiring: _Signs Ballasts 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 hr the Inspector o1IS 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. 1 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 sane to the permit issuing offic p. . CHECK ONE: 1NSt,RANCE BOND ❑ (Specify ) Li&/W`L�SO5orte t✓j�(>6/e. �' �� ❑ OTHER �• 1 certify,under the pains and penalties of pe jury,that the information on this application is True and complete. FIRM NAME: l Y L LIC. NO.: I�)( Licensee: r,C._ .eu Signature (!f applicable,enter •erem t"i the lice,: a number line./ _ Tel. ?\O.: 7 7 69 L Address: 1(j�,l� /' r mil. W r,11 yt,t A Bus.Alt No.: CQ4i 7?r7 d74}3 *Per M.G.L. c. 147, s. 57-61,security work requires De jarttnehtloYfYPublic SafetyAlt.Tel.No.: 737 clgc�y "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)L12wner owner's agent Owner/Agent PERMIT FEE: Signature Telephone No.