The URL can be used to link to this page

Home My WebLink AboutBLDE-23-003838 Ada. Commonwealth of OfflcialUse Only _ Massachusetts Permit No. BLDE-23-003838 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked £Rev.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:1/16/2023 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives nonce of his or her intention to perform the electrical work described below. Location(Street&Number) 35 CONGRESSIONAL DR Owner or Tenant PARUTI ANNE M TR Telephone No. Owner's Address C/O PARUTI DAVID,35 CONGRESSIONAL DR,YARMOUTH PORT,MA 02675 /rO�g� Is this permit in conjunction with a building permit? Yes❑ No 0 (Check Appro<./`� z) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 M New Service Amps Volts Overhead 0 Undgrd 0 n Number of Feeders and Ampacity ... Location and Nature of Proposed Electrical Work: Replacement boiler / Completion of the following table may be war(Y'eDy(hfrvlr Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of / .n.,T Transformers C < � No.of Luminaire Outlets No.of Hot Tubs Generators �i No.of Luminaires Swimming Pool Above d. ❑ IIn- ❑ No.of Emergency Lighting rn 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. oral No.of Alerting Devices ns No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices Na.of Dishwashers Space/Area Heating KW Local ❑ 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 NVo.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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 , s. s - Cu maw!,weait h cf Massachusetts ( t 2 ly Permit o. "--- 2-') -3 8 3 5 , ., De art 1 t of F ,e Services -_ - Occupancy and Fee Checked - _ . OFFIFE 'PREVENTION F:EGUL A.TICNS kRev. 9.03t ' B+:�A, .D J C cave ':)lank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK \ll work to be performed in accordance with the Massachusetts Electrical Code (MIEC). 527 CMR 12.00 (PLEASE PR1-V T IN INK OR TYPE ALL INFORN ATIOX,) Date: / jt ` City or Town of: (14 6 To the Inspector of Wires: By this application the undersigned giv s noticO of his or ler intention to perform the lectrical work describ d be ow. Location (Street & Number) 75 5 �QA .e— S 0 Owner or Tenant 0 avid '}. A( ( - 1 ______ Telephone No. i7_. Owner's .address _____aaa/yN_,Q,_ — l` '� Is this permit in conjunction with a building permit? Yes Li No [1 (Check Appropriate Box) Purpose of Building Utility Authorization No. ._________ Existing Service Amps / Volts Overhead 7 Undgrd E No. of Meters r-1 g New Service Amps i Volts OverheadOverheadL� Undgrd I 1� No. of Meters Number of Feeders and Ampacit♦' ___A_ _. _.._. .. _ ____ ..._.. Location and Nature of Proposed Electrical Work: S .� _ Completion .2I.the,tnllo=e•ing table may be :'aired by they Inspector or i{'ires. No. of Recessed Luminaires No. of Coil.-Susp. (Paddle) Fans 1`o. of Total Transformers KVA _ No. of Hot Tubs Generators KVA No. of t.umtnaire Outlets "-' Above , In- INo. of—Emergence fighting No. of Luminaires Swimming Pool grad. grad. Battery Units �, ., No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Gas Burners No. of Detection and No. of Switchesil Initiating Devices :tio. of Air Cond. Total No. of Alerting Devices No. of Ranges Tons 'Ueat Pump t Nullifier Tens . . .' KWtio. of Self-Contained No. of Waste Disposers 1 Totals:j i _ ,DetectioniAlert;nRDevices .Municipal r"' No. of Dishwashers ' SpaceiA►rea Heating KW_ aLoeal 0 Connection ! Other . ecurity .systems:* No. of Dryers Heating _appliances KWtio.of Devices or E uivalent No. of Water No. of No. of Data Wiring: Heaters KW Signs Ballasts No. of Devices or Et uivalent i Telecommunications 'wiring: No. Hydromassage Bathtubs ,'�o. of Motors Total HP 1 No. of Devices or E uivalent OTHER: . — .' midi additional detail tfde'sircd, or as required hi the inspector q.Wires. Estimated Value of Electrical Work: (When required by municipal policy. ) Work to Start: Inspections to be requested in accordance with MIEC 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 co\eraee is in f.rce. and has exhibited proof of same to the -emit isstilntZ office. _ , .. CHECK ONE: INSURANCE 0 BOND I>#i OTHER 0 (Specify:) (.. I,.4vC t v.) comers Cave a` 1 certify, under the pains and penalties of perjuly, that the information on this applic ton is true and complete. FIRM NAMIE: gIki e.,C0 LIc. No.: 1 I (� Licensee: Signature ~ I.IC. NQ.: 7. 6)-9 _,. tlfapplicable, el 'er `exemp ,,`!i le iceaner line .i / Bus. Tel. No.:5'+,�7 7 `' Address: I N � � . ai f AIt. Tel. No.: 5 7 37 q *Security. System Contractor License required for this wo : if applicable. enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my sinature below. I hereby waive this requirement. I am the (check one) D owner Q owner's anent. Owner/Agent PERMIT FEE:Signature Telephone No. _ _____---__ . ____ - - - ---