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Home My WebLink AboutBLDE-23-002706 e Commonwealth of Official Use Only fI Massachusetts Permit No. BLDE-23-002706 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:11/15/2022 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) 411 ROUTE 28 Owner or Tenant LAER REAL ESTATE Telephone No. Owner's Address 411 ROUTE 28,WEST YARMOUTH, 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: Run new circuit to sign. 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 0 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/Alertine 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: DAVID W SPRINGER Licensee: David W Springer Signature LIC.NO.: 21170 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:70 Bishops Ter, Hyannis MA 026012106 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: $100.00 .---f:i--Cc,N { t4;/v P X �0141)0t T - Dt2.tlOkie•lt/civil) tit o h_3 t> - RECEIVED NOV 15 2022 00'' yy��r ' Co .mega&el rrlassachu.tet(e Officialal Use Only C .e,.T(:;e;.ralNG DEPART aT Permit No. ¢Z2_ 2/OG� 1 lm.n<`.)&n s:.ui rJ �- . BOARD OF FIRE PREVENTION REGULATIONS Occupancy0 and Fee Checked [Rev.1/07] (leave blank) 5:`C' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All wore to be performed in accordmce with the Massachusetts Electrical Code(ME ),527 CMR 12.00 0 c j (PLEASE PRINT IN iNK OR TYPE ALL INFORMATION) Date: N �I S �72,2 (. (� City or Town of: ,, YARMOUTH To the Inspector of Wires: N By this application the undersigned gives notice of his or her intention' to perform the electrical work described below. Location(Street&Number) `1 'I c--)-- Z,p L� IN YoCMr1Jk NJ Owner or Tenant L e, �fct\ e S Ier,"t-t 1l. Telephone No.17r13S3 OSZ Owner's Address N Is this permit in conjunction pith a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building D k,'Y,�� Utility Authorization No. G I Existing Service Amps / Volts Overhead Undgrd_' ❑ g ❑ No.of Meters (...-i New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters <1 Number of Feeders and Ampacity v \ Location and Nature of Proposed Electrical Work: (U n et„.) ,,),re S it 5 Completion of the followingtable m9,be waived by the Inspector of Wires. '! No.of Recessed Luminaires No.of Cell:Sosp.(Paddle)Faos No.of I otal r Transformers KVA '`I No.of Luminaire Outlets No.of Hot Tubs Generators KVA A\ No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighhng grid. g nd. ❑ 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. Tons No.of Alerting Devices 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❑CoMunnnectioicipal n 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of No.of WaterHeaters KW 'No.of No.of Data Wiringvices or Equivalent Signs Ballasts 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 EI trical Work: I S CIO ,,.s (When required by municipal policy.) Work to Start: ..I 1-j-O)Z Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND El OTHER 0 (Specify:) I certify,under the pins and penalties of perjury,that the informa on on this application is true and complete. FIRM NAME: \\ C 1 n5e-(- R {C1-C C, LIC.NO.:Z\176 A Licensee:DO 0 c thgf� Signature /lir LIC.NO.:�3Z'3C B (If applicable,enter"ese,mpt in the cease numbs(((line.) Address: /C k5C. ll5 +CS', AN(N%) But.Tel.No.: i0R �4y ut3� Tel.No.: •Per M.G.L.c.147,s.57-61,security work requ' s Department of Public Safety"S"License: Alt Lie 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. 1 am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$