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Home My WebLink AboutBLDE-22-003280 Commonwealth of Official Use Only XL. , (\\i Massachusetts Permit No. BLDE-22-003280 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:12/9/2021 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) 482 WINSLOW GRAY RD Owner or Tenant GLADYS REYNOLDS Telephone No. Owner's Address 482 WINSLOW GRAY RD, SOUTH YARMOUTH, MA 02664 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 91/ KVA r No.of Luminaire Outlets No.of Hot Tubs Generators 1 ,6 � 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 0 Municipal 0 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 (,vir 'er Tiv141tdigoa 7(14/w 6340 i i ec 4A-0 - E �EI �� y� Le CeLLQ Commonwealth o//r/adsachw[E� '� .� / Official Use Only l '. v P D`�. �' Permit No. re7 iZ-� �'L DEC 0 8`'• i i [ ar(m[aI n ore BraK[5 \ BOARD OF FIRE PREVENTION REGULATIONS BUILDING DEPAR.g ENT Occupancy and Fee Checked 1 i [Rev.1/07) leave blank)By: .-`.-• (CATION FOR PERMIT TO All work to be performed in accordance with the Massachusetts EFttsEORM ELECTRICAL CMR 12.00 WORK (PLEASE PRINT DI INK OR TYPE LL?FORMA ORMA I A9 Date:City or Town of: I�G o` "�— f By this application the undersigned- iva noticeti of his or her intention- perform theTo the [spec car ctor A o Wires: bed below. Location(Street&Number) fj� f// Owner or Tenant i l/U, Owner's Address Telephone N°. Is this permit in conjunction with a building permit? Yes Purpose of Building ❑ NO ❑ (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead New Son ice ❑ Undgrd El No.of Meters Amps / Volts Overhead❑ Undgrd Number of Feeders and Ampacity g ❑ No.of Meters _+ Location and Nature of Proposed Electrical Work: Com lotion of the oliowin table map✓=e rraired br the Ins ectar ol'Wires. No.of Recessed Luminaires No,of Ceil:Sus . )p(Paddle)bans Transformers ota No.of Luminaire Outlets No.of Hot Tubs KVA Generators KVA No.of Luminaires Swimming Poole ❑ 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 No.of RangesTotal Initiating Devices No.of Air Cond. Feat Pum Tons No.of Alerting Devices No.of Waste Disposers p Number Tons KW No.of Self-Contained `Totals: Detection/Alerting;Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connectionu Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water KW T of No of No.of Devices or Equivalent Data Wiring: Heaters Signs Ballasts No.Hydromassage Bathtubs No.of Devices or E uivalent g No.of Motors Total HP Telecommunic so r nog: OTHER: No.of Devices or Equivalent .4ttach addinonal 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 waicec 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 offic CHECK ONE: INSLRANCEIE,BOND ❑ OTHER 0 (Specify:) l.(a/wlkfscrnte 8/cAi0" I certify,under the pains and penalties ofperjtoy,that the information on this application is true and complete.FIRM NAME: l �/ ) � �l� Licensee: w L G e(A LIC.NO.: Signature Tel. N0.:�7a3q C ic enter"exempt-is,,� the liter a number line./ Address:/g(j3,d,. i"YItL�-p nr 4t1`d�( Ned Bus.Tel.No.•5-6 77607d-� *Per M.G.L.c.147,s.57-61,security work requires Deppartm t of Public Safety-S"License: Alt l e No. $�737 4d Y OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)Q owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ 50' iS�IS C� 13a I f i • • • • • • • •