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Home My WebLink AboutBLDE-22-006871 0Commonwealth of Official Use Only i Permit No. BLDE-22-006871 \� Massachusetts `�'/ 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:5/27/2022 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) 1146 ROUTE 28 Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd IDNqi of Meters New Service Amps Volts Overhead 0 Undgrd 0 Neoso);,Meters Number of Feeders and Ampacity 4, 0 Location and Nature of Proposed Electrical Work: Re-wire cooling tower. V Completion of the following table 14, , /I1 ,:"' Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Q o Transformers No.of Luminaire Outlets No.of Hot Tubs Generators No.of Luminaires Swimming Pool Above In- ❑ No.of Emergency Lighting I 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 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/Alerting 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 Siens 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: John H Brewer Licensee: John H Brewer Signature LIC.NO.: 14092 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:205 CEDAR ST,W BARNSTABLE MA 026681324 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: $0.00 T� u7 r csie:� PtAl ri lit.- 4 t (z-z E -- gLN Commonwldth o`///aau:ch.:will Official Use Only -.,.,...�., t ccyy�� Serviced Permit No. �� 67 1 e .D•_"' 1Jlpart°unl 1. ire I�...I Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS (Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M 27 CM!,I .°° (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: .) S/ City or Town of: YARMOUTH To the Ins for of W By this application the undersigned givel notice of his or her intentionto perform the electrical work described below. / Location(Street&Number) l 6IS'1 p • � -3 Owner or Tenant ✓ f,A,I//)2(7// iUN//� Telephone No. Owner's Address ✓ Is this permit In conjunction with a building permit? Yes ❑ No 14 (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: j A i 0• Completion of the jollowin table may be waived by the Inspector of Wires. Total Ui No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tra of KVA `! Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting geed. grad. 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 Ill No.of Ranges No.o'Air Cond. Tons) No.of Alerting Devices No.of Waste Disposers Pump Number.,Tons_..._,KW No.of Self-Contained Totals: '.""'. Detection/Alertln Devices No..of Dishwashers Space/Area Heating KW Local 0 Cyaonnni:%in ❑other No.of Dryers Heating Appliances KW Security * o f Devices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters SignsBallasts Na 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 Stan: 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 permit issuing office. CHECK ONE: INSURANCE❑ BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the informed° n this application Is true and complete. FIRM NAME: LIC.NO.: Licensee: — Signs LIC.NO., :.•.9 51 ye (If applicable,enter"exempt"in the license number line.)..- Bun.Tel.No. / Address: Alt.TeL No44,0.--' a,y ty Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. V} 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)❑owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$