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Home My WebLink AboutBLDE-23-002053 v Commonwealth of Official Use Only 11 Massachusetts PemlitNo. BLDE-23-002053 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:10/18/2022 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) 14 DEBS HILL RD UNIT 7B 77L-487—a S4S Owner or Tenant FEHRNSTROM WILLIAM H Telephone No. Owner's Address FEHRNSTROM DOROTHY F, 14 DEBS HILL RD, 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: Install generator 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 1 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 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 ❑ 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 (4'9k VA Ca'' 3 C'411 LlA) Commonwealth o`lrlaaeachnaetia Official Use Only P. / cc�� 77 i Permit No. �Z3--WS3 w , aretrimenl al Jive Jewices 1 i` $ Occupancy and Fee Checked -• BOARD OF FIRE PREVENTION REGULATIONS Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ail work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN LVK OR TYPE LL'/I4FOR A iOAt) Date: 10 —t("' — City or Town of: a 1 Q To the Inspector of Wires: By this application the undersigned1 g'i es notice of hi$or r:nte m to perform the electrical work described below. Location(Street&Number) ,—1 am 44 Owner or Tenant P€ii1r rt --}re_144 Telephone No. 77/^(? 7 Owner's Address '5 a.. ...Q ySYS- is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps I- Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / _Volts Overhead❑ Undgrd El No.of Meters _ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: W i{ Completion of the following table may he waived hi.the Inspector of(tires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVAVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above r- in- ❑ No.of Lmergency 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.of Detection and _ initiating Devices No.of Ranges No.of Air Cond. Total Tons No.ai Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW "No.of Self-Contained P Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑CoMunicipal cho ❑Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Waterer Qo of No.of Devices or Equivalent Heaters KW Data Wiring: _ins Ballasts No.of Devices or Equivalent No.Hrdroassage Batbtnbs No.of Motors Total HP Telecommunications Wiring: tn 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: 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 force,and has exhibited proof of same to the permi ssui gP ffic . CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) ttii6/4,6�'vi P f )G I/i. a0"a3 I certify,under the wins and p n es ofperjtmthat the information on this application is rue and complete. FIRM NAME: ,/,JIv'deco 6j2C 'nCC. LIC.NO.: I.. /I6A Licensee: -,Y i L .tit -eV) Signature LIC.NO.: c)- a (� of applicable,ems{ "temp"dn ens n ber line./ Bus.Tel.No.' Address: 0 'y1D inn dCl co it( (,(I, if Alt.Tel.No.: "Per M.G.L.c.147,s.57-61,security work requires epartment of Public Safety"S"License: Lic.No. 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 0 owner's agent. Owner/Agent I PERMIT FEE:$Signaturetune Telephone No.