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Home My WebLink AboutBLDE-23-003475 Commonwealth of Official Use Only A '. ,:1Massachusetts Permit No. BLDE-23-003475 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:12/23/2022 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) 23 DUNDEE DR Owner or Tenant ROWE RICHARD L JR Telephone No. Owner's Address ROWE SUSAN G, 23 DUNDEE LN,YARMOUTH PORT, MA 02675-1518 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 Number of Feeders and Ampacity g -..„ No.of Meters Location and Nature of Proposed Electrical Work: Wire gas 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 gr boyend. ❑ g rnd. ❑ No.of Emergency Lighting Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I 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 No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent 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: 12/14/2022 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 operjury,that the information on this application is true and complete. .` FIRM NAME: ERIC W DREW Licensee: Eric W Drew Signature I LIC.NO.: 13118 (f applicable,'° ble,enter"exempt"in the license number line.) Address: 103 MID TECH DR,UNIT A,W YARMOUTH MA 026732588 Aus Tel. o.:: Alt. *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Tel.No.: 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 i/7j3 20 J/A (MOF e ✓k b --Fee-..f , 'Q.. - .. Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. CZ3- gg7s- 1{ i Occupancy and Fee Checked y. �' '�• BOARD OF FIRE PREVENTION REGULATIONS i� 1 Rot.9 0� —4'e blank) 1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK. All work to be performed in accordance tivith the'•lassachusetts Electrical Code(MEC),527 C'�tR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFOR.%fA TIO.N Date: �( ` -'' "" City or Town of: tiartm0 (kV} 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 x Number) p23 pu y��p.1 41. 3�j0 d 3 ea.t �. Owner or Tenant �4,n e., , r r � Telephone No. /VYL Owner's AddressjQ ..Q.. `� Is this permit in conjunction with a building permit? Yes r No E (Check Appropriate Box) Purpose of Building, Utility Authorization No, Existing Service Amps / Volts Overhead E t'ndgrd No.of Meters New Service Amps / _Volts Overhead _ Undgrd C Na.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: iP Ve/ jer-- Comple:'Cimri of tlicyfblloaing table may be waived by they InspToector of Wires. No.of Recessed Luminaires No.of Ceil-Susp.(Paddle)Fans NO.of tal �Transfornters KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of LuminairesAbove In- No.of Emergency Lighting -"Swimming Pool rnd. t_�rnd. ❑ Battery Units No.of Receptacle Outlets Na.of Oil Burners �. —.. ' FIKE ALARMS No.of`Cones No.of Switches No.of Gas Burners o. of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of waste Disposers Heat Pump .Number Tons KW No. of Self-Contained No.of Dishwashers t Totals: , Detection/Alerting Devices Space/Area Heating N Local1lunicipa} 0 Connection ❑ Other No.of Dryers `Heating appliances NW Security Systems:* m No.of Water No.ofo No.of Devices or Equivalent Heaters NWSigns Ballasts Data Wiring: No. Hydromassage Bathtubs No.of}lotorsNo.of Devices or Equivalent To#a}}IP Telecommunications VS tring: OTHER: ---- S No.of Devices or Equivalent .f ttach addirornd detail(f desired, or as required by the Inspector of it'irr,, Estimated Value of Electrical `~Work (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with 31EC 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"coyera7e or its substantial equivalent. The undersigned certifies that such coverage is in f.rce, and has exhibited Proof of same to the, •rtnit issuing office. C'IiECK ONE: INSURANCE ❑ BOND 11,4 OTHER 0 (Specilye) (4;:a490( W comp I certifj., under thepains and penalties of perjury, that the information on this applic'ttfibn is true and rs complete. ^a� a� F1RNI NAME; (41 w Licensee: LIC. NO.: 1.31( Signaturti �''' .. 1�^ (If applicable, 24er "erenr t",err e ice!se t zit ibex lime i IC. NO 7�7 Address: Bus.Tel. No.: j r 77�rU�d Alt.Tel:No.: *Security System Contractor License required for this wo ; if applicable,enter the license number here: S ?3�y9� OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally e required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑owner owner's agent. OwnerlAgent Signature Telephone No. PERMIT(#T FEE: