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Home My WebLink AboutBLDE-23-003889 Commonwealth of Official Use Only v Massachusetts Permit No. BLDE-23-003889 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked lRev.1/071 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:1/18/2023 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) 4 WOLFSON RD Owner or Tenant RICK ADAMS Telephone No. Owner's Address 4 WOLFSON RD,SOUTH YARMOUTH,MA 02664 Is this permit in conjunction with a building permit? Yes ❑ No .0 Check Appropriate Box) Purpose of Building Utility A r ti Existing Service Amps Volts Overhead ❑ -,411 : • eters New Service Amps Volts Overhead 0 . 1 Number of Feeders and Ampacity I Location and Nature of Proposed Electrical Work: Replacement boiler. 0 Completion of the followt <V Waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of /1 Total Transformers !/ KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- CINo.of Emergency Lighting grnd. �rnd. 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 0 Other: Connection No.of Dryers Heating Appliances NW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent 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 ❑ 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 j OfficialseOnly� �,}— ¢_ Department of Fire Services i Permit\o._ > V, -3�9 t r - Occupancy'and Fee Checked " , BOARD OF FIRE PREVENTION PEGULATICVS 4(Re�.9 0'J (.eaec,lankl APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in aceerdan,, the Massachusetts Electrical Cede(MEC). : CN1R 12,00 (PLEASE PRINT IN LVK OR TYPE.41. I1`FOR.11.4 TI \'1 Date: ( - i — as �[City or Town of: �_ mo To the Inspector of Wires: By this application the undersigned gives n lice of his or her i .t ion to perform the electrical work described below. Location(Street& Number) W Owner or Tenant _ Telephone No. Owner's Address tCJ is this permit in conjunction with a building permit? Yes 7 No ❑ (Check Appropriate Box) Purpose of Building I..tility Authorization No. Existing Service Amps / Volts Overhead J Undgrd C No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampaeity Location and Nature of Proposed Electrical Work: t Completh, rho following table may he i:'aived hi the Inspector of it i e,. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No Transformers KVA No.of Luminaire Outlets No.of Hot Tubs }}Generators KV A No.of Luminaires Swimming Pool Above C ln- ❑ iNo.o[ mergency' Lighting grad. ornd. Batters. 1.nits No.of Receptacle Outlets No.of Oil Burners iFIRL ALARMS No.of Zones No. of Detection anii No.of Switches No.of Gas Burners Initiating Devices Total No.of Ranges No.of Air Cond. Tons No. of Alerting Devices Heat Pump !Cumber Tons i KW No.of Self-Contained No.of Waste Disposers I Totals: , jDetectiontAlerting Devices No.of Dishwashers !Spacel.Area Heating KW Local❑ :Municipal echo ❑ Other Connection No. of DryersKW;Heating Appliances K Security Systems:* No.of Devices or Equivalent No.of Water K�`. No.of No. of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total hie Telecommunicat ons ti iring4_ v No.of Devices or Louis alert 1 OTHER: Attach additionil detail if desired, or as t•egrriveti hi the Itb/lector of I;irc,. Estimated Value of Electrical Work: (When required by municipal policy.I 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 tie performance of electrical work may issue unless the licensee pros ides proof of liability insurance including"completed operation'. cos eragc or its substantial equis alert The undersigned certifies that such coverage is in force. and has exhibited proof of same to the t -Emit issuing office. CHECK ONE: INSURANCE ❑ BOND ISL OTHER ❑ (Specify:) (,( ib( lt. wailers Col 4-a�- d3 I c•ertir, under the pains and penalties of perjury, that the information on this appli ton is true and complete. FIRM NAME: ,( ) LIC. NO.: I?/( Licensee: (/ Si natur� _ ----__ - g LiC. NO.: 1 Ili-applicable. ewe,: "e.te1mnt' n to is lie number linel t�� Bus.Tel. No.:5CV 7'7�C� a3 Address: '.! n I/Ci -rO vi7 th V( Alt.Tel.No.: SOff, 737y`I4 *Security System Contractor License required for this wo : if applicable. enter the license number here: �I OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not Jane 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 agent. Owner/Agent Signature Telephone No. PERMIT FEE: S