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Home My WebLink AboutBLDE-23-005693 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-0056933 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:4/13/2023 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) 52 BARNACLE RD Owner or Tenant JOHN BREEN Telephone No. Owner's Address 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 boiler 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 1 No.of Detection and Initiating Devices Tota No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 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. romassa H d a Bathtubs No.of Motors Total HP Telecommunications Wiring: y g 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 pen-nit 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 Commonwealth of Massachusetts Official Use On nll/y Department of Fire Services 3_ Occupancy and Fee Checked Y;- BOARD OF FIRE PREVENTION REGULATIONS [ Occupancy (deFee 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 TYPE ALL INFORMATION) Date: 11—S -d-3 City or Town of: C GOL/LA To the Inspector of Wires: By this application the undersignedgives no ce of his or her i tenti t erform the electrical work described below. Location(Street& Number Owner or Tenant U 6 hleiAym Telephone No. Owner's Address Q Is this permit in conjunction with a buildin��e__ - No ❑ (Check Appropriate Box) Purpose of Building �eS- Utility Authorization No. Existing Service Amps / Volts Overhead E Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd E No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (13 Ire V) l -eK-- Completion of the following table may be waived hr 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 No.of Luminaires Swimming Above In- No.of Emergency Lighting Pool grnd. 0 grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones Na.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Tons Total No.of Alerting Devices Heat Pump I Number I.Tons I KW No.of Self-Contained No.of Waste Disposers Totals:1 Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local 0 Connection Other .Appliances KW Security Systems:* No.of Dryers 1Heatin g Pp No.of Devices or Eguivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or E uivalent elecommunu:atIons 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: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by th,uowner,ompleted operation performance corage or t ectrical work may issue subs-tanital equivalent. unless the licensee provides proof c liability insurance me w r5 4'.as- a3 undersigned certifies that such coverage is in force,�THER exhibited❑ {Sp proof ° ,,,,,\`the r oiro mit issuint;office. BOND ri lr ton is true and complete. CHECK ONE: INSLRArCE ❑ that the information on this app L,1C,NO.: I I certify,Lander the pains and patties of perjury, L1C.NO.: 37 7 D FIRM NAME: Signature Bus.•Cet.`o•� 7 Licensee: Alt,Tel.No.: applicable,a er•"exert t",gin a ice ise r u ben line) . {I app , if applicable,enter the license numlye;u�ance coverage normally Address: owner ❑owner's a eat. *Security System aware that the Licensee does not hare the liability stem Contractor License required for this "o uirement. I am the{check one) OWNER'S INSURANCE WAIVER: tam PERMIT FEE: required by latz• By my signature below,I hereby waive this requirement. Owner/Agent Telephone Signature _____� ----