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HomeMy WebLinkAboutBLDE-23-001767 '- r Commonwealth of official Use only ..„iiii,37 Massachusetts Permit No. BLDE-23-001767 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:10/4/2022 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) 41 MINNETUXET WAY Owner or Tenant SIMS RUTH S Telephone No. Owner's Address 41 MINNETUXET WAY, YARMOUTH PORT, MA 02675 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 ❑ Undgrd ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace panels&install generator 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 1 KVA No.of Luminaires Swimming Pool Above ❑ In- ElNo.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 0 Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No No.of Devices or Equivalent HeatersWater KW No.of No.of Ballasts Data Wiring: 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 Si ature Telephone No. I I PERMIT FEE: $50.00 7,4- ( 2 (t k ` Commonwealth 6.17///�j / Official Use Only + a�sachu�al _ _ aLJeparttmenf mire�ervicei Permit No. Z1?(p�J 1 Occupanct\ y and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) (leave blank) 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 TYP ALL INFO TION) Date: City or Town of: a f p�t To the Inspector of Wires: By this application the undersigned 'ves notice of his or her intention to perform the electrical work de ribe below. Location(Street&Nu ber) 41 Owner or Tenant —_ elephone No. <` -- Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No /O6 E (Check Appropriate. Box) Purpose of Building — Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd � g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd g E No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: • Completion of the following table may be waived by the Inspe for 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 INo.of Zones _�' No.of Switches No.of Gas Burners No.of Detection and Initiating DevicesTot No.of Ranges No.of Air Cond. Tons No.o.: lerting Devices No.of Waste Disposers Heat Pump 1 Number I Tons fKW 1NNo.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 ecunty systems: No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Si Ballasts � _lips No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors TOWHP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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: p p° y� 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 permi 'ssui Mic . CHECK ONE: INSURANCE 11 BOND 0 OTHER �i/./� p 16.0 [ _30 ..cD3 I certify,under the sins and p na• 'es© er• 0 (Specify:) N` � FIRM NAME: f J ry,that the information on this application is ue and complete. Licensee: - r' L ,p LIC.NO.: �511 /I (If applicable,ant �em Signature "anline) LIC.NO.: �} a Address: p ens n ber -- --- Bus.Tel.No.: *Per M.G.L.c. 147,s. 57-61,security work requires apartment of Public Safety"S"License: Alt.L cl•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/Agent Y Signature ®owner's -- ___ Telephone No._ IjIEE:$ t