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Home My WebLink AboutBLDE-23-004966 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-004966 > 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:3/9/2023 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) 418 ROUTE 6A Owner or Tenant KUHFAHL SANDRA J Telephone No. Owner's Address 418 ROUTE 6A,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 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 No.of Ranges No.of Air Cond. 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 z/c(- Commonwealth of Massachusetts official Use Only k I Permit No. .iZ.5--�C Z i Department off Fire Services moo Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS "(Rey-.9 05] plank,) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ail work to be performed in accordance with the Massachusetts Electrical Code(\4EC},527('MR 12.00 (PLEASE PRINT IN LVK OR T' Er.1. t--\ OR b1.I T10N) Date: 3 A:, City or Town of: AU U To the Inspector of Wires: By:this application the undersigns gives notice of his or er intention to )erform the e ctrical ork described below. Location (Street& Number) �{ QrM b Owner or Tenant LU 1/k, Telephone No. 5C 36a Owner's Address , at 51. is this permit in conjunction with a building permit? Yes No E (Check Appropriate Box) Purpose of Building _ Utility Authorization No. Existing Service Amps / Volts Overhead E Undgrd No.of Meters New Service Amps / Volts Overhead[ Undgrd [ No.of 1•Ieters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: � ;(e i "r Completion of the fcrllo:ring table May hc w:;h•ed by the Inspector of It'ires. Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tr of KVA Transformers k��A No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency LighTing No.of Luminaires Swimming Pool ornd. C gptd. ❑ Battery L'nits No.of Receptacle Outlets No.of Oil Burners hFIRE ALARMS No.of Zones o. of Detection and N No, of Switches No.of Gas Burners Initiating Devices If Total No.of Ranges No.of Air Cond. Tons iNo.of Alerting Devices fi Na.of Waste Disposers ,Heat Pump I Number Tons I I;.\! !No.of Self-Contained p i Totals: . I Detection/Alerting Devices ? unicipal No. of Dishwashers ;Space/Area Heating KW tLocal❑ 'M Connection ❑ Other No. of Dryers EHeating Appliances KW . ecurtty Systems:* No.of Devices or Equivalent No.of Water KW No.of No. of l Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No:of Motors Total HP Telecommunications Wiring: g No.of Devices or Equivalent OTHER: - _.4:oclx addiiir: al detail{fde sod, or tit.required lby i/tcInspector of it"(res. Estimated Value of Electrical Work: _ (When required by municipal policy.t Work to Start: Inspections to be requested in accordance with\IEC Rule 10.and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for tie performance of electrical work may issue unless the licensee provides proof of liability insurance including."completed operation-coverage or its substantial equivalent. The urdersiened certifies that such coverage is in force,and has exhibited proof of same to the rmit issuing office. CHECK ONE: INSURANCE ❑ BOND [V•OTHER ❑ (Specif}:I tia.4X'\c /Wovt-ers Co 4--as- ?-3 I certify, under the pains and penalties of perjuty, that the information on this appli icon is true and complete. FIRM NAME: a-(,tf /GO LIC.NO.: 13! Licensee: ' (r (7Q/4 Signaturty.-," _ /fY-- LIC. NO.: i (I/applicable, e er "ecetttvt'",fir, 2e ice:rise r eu t6er linr 1 Bus.Tel.No.:,j O1 77 O - Address: t Mjn P vy � . y0i Alt.Tel.No.: <SO� 737(-MD? *Security System Contractor License required for this wolk; if applicable.enter the license number here: l OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nor have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one)0 owner ❑ owner's agent. Owner/Agent PERMIT FEE:Signature Telephone No.