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Home My WebLink AboutBLDE-23-000545 Commonwealth of Official Use Only ;rim, Massachusetts Permit No. BLDE-23-000545 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) 482 WINSLOW GRAY RD Owner or Tenant Gladys Reynolds Telephone No. Owner's Address 482 WINSLOW GRAY RD, 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 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement condenser. 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. 1 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 0 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: $50.00 j�1/ �n/� Official Use Only Commonwealth, o f Pla96achtdetis .G.��o�� , cc� c7 Permit No. �(•� .._— T epartmerzt al.fire Services _•—'= ' Occupancy 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),5_7 CMR�12.00 (PLEASE PRINT IN INK OR TYPE ALL INFQR,'t1ATION) Date: e)"r CT )----- City or Town of: Cr W To the Inspector o/ Wires: By this application the undersigned Ytves notice of his or her intention to perform th electrical.e or escribed below. Location (Street& Number) LtS )— il(1Si C .5 - 0 Owner or Tenant �.J C a. J LI Telephone No., i( 51 7 Owner's Address _ Is this permit in conjunction with a building permit? Yes El No l + (Check Appropriate Box) Purpose of Building Utility Authorization No. - Existing Service Amps / _Volts Overhead E Undgrd 1 1 No.of Meters New Service Amps / Volts Overhead I I Undgrd 1 No.of Meters -- Number of Feeders and Ampacity _ Location and Nature of Proposed Electrical Work: J( Y L C dtc—( i7 Completion(f the following table may be waived by the Ins.)ec•tor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No. f T l Tranosformers KVAVaA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.oI 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: rDeteetion/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances K`' Security Systems: No.of bevices or Equivalent No.o Water Kam,. No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: j Attach additional detail if desired, or as required by the Inspector of Wires.l Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with IvMEC 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 overage is in force,and has exhibited proof of same to the pe nit issuing office. CHECK ONE: INSURANCE iiLl BOND ❑ OTHER El (Specify:) UO, 19( , 41 Sc(,1't�G 6)—3b}64-c I certify', under the pains and .ena 'es of perjury,that the information on this appticati n is true and co>itplete. FIRM NAME: _ LIC. NO.: f 3) ((?A- Licensee: G. (L., �� Signature S - LIC. NO.: L (If applicable, enter " emp ' e l c se number line.' Bus. Tel.No.:- O 77 ) 6 7.�..R Address: � 1(0- �Y----�'(t_(ea()U`�'1 Alt.Tel.No.:SOO 7'�7 te4?-- Per M.G.L. c. 147, s. 57-61,security work requir s Department of Public Safety"S"License: Lie.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's a ent. Owner/Agent PERMIT FEE: $ Signature Telephone No.