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Home My WebLink AboutBLDE-23-000546 O ...... 57 ft* `'Commonwealth of t)fficial Use Only Massachusetts Permit No. BLDE 23=Obo546 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:8/2/2022 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) 1 TURNER LN Owner or Tenant PINA DEBRA J THOMSON Telephone No. Owner's Address 1 TURNER LN,SOUTH YARMOUTH, MA 02664-3141 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. ',1';,:. Existing Service Amps Volts Overhead 0 Undgrd 0 a :': New Service Amps Volts Overhead 0 Undgrd 0 i' No of[t § Number of Feeders and Ampacity i �' -.., �,'� 1 p¢ " Location and Nature of Proposed Electrical Work: Un-identified work. -,..,-.1 . a t , ^' Completion of the following table may be waiver by th2-Irlspector of Wires. No.of Recessed Luminaires No.of Ceil.Susp.(Paddle)Fans No.of Total Transformers ` ',i ,. KVA No.of Luminaire Outlets No.of Hot Tubs Generators ''' I, 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 Initiatine Devices No.of Ranges No.of Air Cond. TotalTonNo.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self;Contained Totals: Detectiotnlertine Devices No.of Dishwashers i, 'G Space/Area Heating KW Local b.,,-'..Municipal 'Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW . No.of No.of Ballasts Data Wiring: Heaters Sinus No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 • Co m nu)n w e a iii, oto Mamackdett3 Official Use Only 'll3viitttt e Permit No. ll' '11114.-Ti .2)epartment,2,15ire Service:s BOARD OF FIRE PREVENTION REGULATIONS v., iirROcAc.cuipt7nicy and Fee Checked — I. • blank) ! APPLICATION FOR PERMIT O PERFORM ELECTRICAL WO All work to be performed in acccrdance with th T e MI:ssa RKchusetts Electrical Code(MEC).:527 CNIR 1'1.00 (PLEASE PRINT LA.INK OR TYPE ALI. INF R11-1TIONi Date: 7- City or Town of: To the In r specto of WiPes: By this application the undersku;ed j.k es notice of his or her imention :o perform the electrical•o...ork described below. Location (Street& Number) .1::_ a_g_r__4_ So .-p rf if 0,t i-(4 Owner or Tenant Debra. Pi A.a.-- Telephone No. 771/ 65 Owner's Address _ Is this permit in conjunction with a building permit? Yes L I N. .o Li 1----, (Check Appropriate Box) Purpose of Building_ Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd --1. No. of Meters New Service _ Amps / Volts Overhead ri Undgrd Li No.of Meters _ Number of Feeders and Ampacitv . _ — Location and Nature of Proposed Electrical Work: • . Completion?Ilk,ibilowing table may he“aired I't the Inyectre of it No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle) Fans 'No.of Total 'Transformers KVA 1 No. of Luminaire Outlets No. of Hot Tubs Generators KVA Above r---, In- ri No.of Emergency Lighting Na. of Luminaires Swimming Pool ond, 1--- grnd. 1----J Battery Units . . i! . No.of Receptacle Cutlets No.of Oil Burners iiFIRE ALARMS No. of'Zones lif ad , No.of Switches No.of Gas Burners No.oDetection II. I nitia ring Denvices Total No, of Ranges No. of Air Cond. 7%;(.t.of Alerting Devices t, Tons No.ofWeD eat Pump Number Tons 10y No.of Self-Containeda i Totals: j)etection/Aterting Devices ri NIunicipal r---1 No. of Dishwashers Space/Area Heating KW f!local Li Connection Li Other No.of Dryers Heating Appliances KW' .ecurity:systems:- No.of Devices or Equivalent No.of Water— KW No.of No. lf Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent _ Telecommunications Wirinu: No. H,ydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivaent _ OTHER: . Attach addittomd detail it decired. or as required hy the Inspector of Il'irek. 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 ini:y issue unless the licensee provides proof of liability insuran,:e including"completed operation"coverage or its substantia equivalent. The undersigned certifies that such coverae.e is in force.and has exhibited rroof of same to the permit issuing utile‘. r CHECK ONE: INSLRANCE71,130ND El OTHER 0 (Specify:) t'ic-/161C{S 65frvie I certify,under the pains and penalties of per jury, that the information on this application is zrue and complete. FIRM NAME: C 4" ) (./14.C-- --- — LIC.NO.: !M M - ' '.---- ----- Licensee: -tac._, L.,Yecu Signature _ Z---:e LIC.NO.:c).7e., 9 L--; d.fapplicchle. enter -exempt'law license number line., Bus.Tel.No.:_„",.,_LZ,$__67 .1 Address: 103A, f .. . Alt.Tel. No.: z)5 77 via-if • .Per M.G.L. c. 147,s. 57-61.security work requires Deartmcit of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hare the liability insurance coverage normally required by law. By my signature below. I hereby waive this requirement. I am the(cheek one El owner 0 owner s agent. Owner/Agent FiRMIT FEE: S , Signature Telephone No. /"...., / '