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Home My WebLink AboutBLDE-23-005024 0Commonwealth of Official Use Only L. j � Massachusetts Permit No. BLDE-23-005024 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:3/13/2023 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) 49 SIERRA WAY Owner or Tenant MATT MULLEN Telephone No. Owner's Address 49 SIERRA WAY, WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Apl3rejlriate Box)- Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 o e' '+�j� ti New Service Amps Volts Overhead ❑ Undgrd 0 e . il Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement boiler. 8 ‘i'' , Completion of the following table may be waived.by.:the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.ofTrans formers `.Total 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 Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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.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 ❑ (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: $50.00 e\s Commonwealth of Massachusetts Official Use Only ,1 Department of Fire Services Permit No. Z3 �� 1 T Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS tRev.9'05) (leane'elankl APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance frith the Massachusetts Electrical Code(blEC),527 C.NIR 12.Oo (PLEASE PRINT IN INK OR TYPE ALL LV"FOR�.�1IATION) Date: 3-v`- City or Town of: /O s.44 To the Inspector of Wires: By this application the undersigned_iv s notice cof.bis or her intention to perform the electrical work described below. J Location(Street&Number) g 1`e • U(tA Owner or Tenant Te phone No. C Owner's Address 'CL 66 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity ` ✓ Location and Nature of Proposed Electrical Work: W YP V d(veI Completion of the follotrin$mble mar be waived hr the Inspector of[Mires. Total No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans Tf _Trr Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Paul Above In- ❑ O.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.on Initiating on Dete and Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained P Totals: Detection/Alertingg Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other Compaction No.of Dryers Heating Appliances KW Security Systems:* No.of bey ices or Equivalent No.of Water K`ti, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.H•dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: g No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Aires. 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 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 f rce,and has exhibited proof of same to the tify, rmit issuing office. CHECK ONE: INSURANCE ❑ BOND _OTHER 0 (Specify:) l(p bt)t w ov�erS Comp Q-as-?-3I cer ,under the pains and penalties ofperjury,that the information on this appli t n is true and complete. FIRM NAME: Cu.! }{�i(s..) LIC.NO.: 1 jt(� Licensee: i i)y(/L\ Signaturg —' LIC.NO.: 37 a/a licable,!pier Texaco t' 'n a�rc 'se u ber line/ Bus.Tel.No.. 7 3 Address: l,1 (r I0ct�)V ( Alt.Tel.No.: > *Security System Contractor License required for t is wok;"if applicable.enter the license number here: `Z 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)0 owner ❑owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No. -- - - ' �.�~ ' ~�� ~ . ' ' ' � ' . \ � � _ . 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