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Home My WebLink AboutBLDE-22-003350 Commonwealth of Official Use Only E• Massachusetts Permit No. BLDE-22-003350 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:12/13/2021 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) 17 WOODCREST LN Owner or Tenant KALFOPULOS ARTHUR F Telephone No. Owner's Address HEIER IRENE&KALFOPULOS CATHERINE, 551 WARWICK LN,VENICE, FL 34293 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 ❑ 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: Replacement boiler. _ _ Completion of the following table!'"e atvid 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 '- a' 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 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 ❑ 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 Eauivalent 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 gg I Cn ontmonweafl/i o/�aaeachuea/tf - Official Lie Only . Y _ �`N �(.Japaetmeat u�.}c7ire�ervice.f Permit No. :� � t Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS I[Rev.1'07) I Cease blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Al:cork to be performed in acscrdance kith the\icsiachusetts Electrical Code(MEC).52'CMR 12.00 (PLEASE PRINT Lt'INK OR TYPE ALL I FgR.yt9 T/O.\) Date: It)-.- /3 - ,,? City or Town of: �YyytU " To tm e enspector of k Wires: By this application the undersigned etv es notice of his or her intention:o perform the electrical cork described below. Location(Street&Number) 17 „,5 A,, ( ,,, , .7 j 7ff^�,�",> Owner or Tenant p ,p,- (��1 y [�L-Y "` Q�t r Telephone No. Owner's Address_ 4.4 -)2 Is this permit in conjunction with a building permit? Yes No ❑ ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Sersice__ Amps / Volts Overhead❑ Undgrd❑ No.of Meters New-Service rhea- Amps / �olts Overhead❑ L"ndgrd❑ No.of Meters Number of Feeders and Ampacity - Location and Nature of Proposed Electrical Work: (4 I ( re_ (-),cp 1 ioO( \. t/- Cnns,,lesi,,,,if she(allotrin,table mar be 1,aged br the Its,ector oft!' e.. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.0 Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above C n- ❑ B.-o.o mergency Lighting _ grad. end. Batten Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners o.o election and Initiating Devices No.of Ranges No.of Air Cond. —T'��gl No.of Alerting Devices —_p No.of Waste Disposers •Heat Pump I Number 1 Tons . o.o e - ontaine Totals: Detection/Alerting Devices ( No.of Dishwashers Space.'Area Heating KW Local Municipal ❑Connection 0 Other No.of Dryers Heating Appliances KWecu ty Systems:* No.of Water '•Tof Data of sices or Equivalent No.A. Heaters KW Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors - -Total HP a ecomrnunications Whin No.of Devices or Equivalent OTHER: Attach additional detail,/desiree..or as required by the inspector of II'ro. Estimated Value of Electrical Work: (When required by municipal policy... Work to Stan: Inspections to be requested in accordance with MEC Rule IC.and upon completion. INSURANCE COVERAGE: Unless waiver 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 oftic CHECK ONE: INSLRANCE BOND 0 OTHER ❑ (Specify) GictiLJ(G{SCOHA(0 8 a513a- I certify,under the pains and/penalties of perjury,that the information on this application is true and complete. FIRM NAME:�C. rb ?�rJ' C �c+ A - �__ LIC.NO.: '3J(VT Licensee: t Y /C� .e(,d Signature . LIC.NO.:,-).7e39 L- (If applicable.enter•'esen ! rite licen.a number!lne.t Address: f03A WI i A 1 eCF1 flt' w (1� Bus.Tel.No.:SQa 77 7 07d3 *Per I.G.L.c.147,s.57-61,security work resuires Bee arm t of Public Safety"S"License: Alt L cTe'No,. 737 V4c1Y OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hare 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