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Home My WebLink AboutBLDE-22-003684 Commonwealth of Official Use Only 11. ,I Massachusetts Permit No. BLDE-22-003684 cy 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:1/3/2022 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) 11 THRUSH TRAIL Owner or Tenant COMEAU MARY ANN GRAY Telephone No. Owner's Address 11 THRUSH TRAIL,YARMOUTH PORT,MA 02675 Is this permit in conjunction with a building permit? Yes❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. C Existing Service Amps Volts Overhead ❑ Undgrd 0 No. New Service Amps Volts Overhead 0 Undgrd 0 i1, ,w,f7�M'e r. `n•�///� Number of Feeders and Amp sad ``` ,T Location and Nature of Proposed Electrical Work: Replacement boiler&W/H. `{,//� Completion of the following table may be waive�t Ir Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 'V�,1 Transformers No.of Luminaire Outlets No.of Hot Tubs Generators �j/3 KV No.of Luminaires Swimming Pool Above ❑ In- 0 No.of Emergency Lighting grnd. grnd. 4111. 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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons 1 KW ,No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local El Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:• No.of Devices or Equivalent No.of Water 1 KW No.of No.of Ballasts Data Wiring: Heaters ,Siens No.of Devices or Equivalent No.H7dromassage 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 cert(fy,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:S50.00 * Co►runonwaaan o//rlasaac�ivaa a I d t Official Use Only ' y -Uapartment a/jire Serviced No. -3� 4 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] leave blank) _ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO AM work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 1 AO �,K (PLEASE PRINT IN INK OR T P AL INFOR TION) Date: City or Town of: - ,-- _ To eres: By this application thz.undersigned fives notic of his or er intention to, dorm thee e xritor l wo of des nbed below. Location(Street&Number) ( ,p� Owner or Tenant • r' l __ Owner's Address - Telephone No. �� -,) - Is this permit in conjunction with a building permit? Yes ❑ No '_ S, Purpose of Building ❑ (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead n Undgrd❑ No.of Meters _ New Service Amps / Volts Overhead I I Undgrd Number of Feeders and Ampacity g ❑ No.of Meters Location and Nature of Proposed Electrical Work: 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 ❑ In- ❑ No.of 1E mergency Lighting grad. rnd. 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 an Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number ,Tons KW -No.of Self-Contained Totals: i Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal i Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water K�,,, No.of No.of Devices or Equivalent No.of Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs-- No.of Motors Total HP Teteco No.of of ca tons trtng: 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 permit issuing offic . CHECK ONE: INSLRANCE'BOND ❑ OTHER ❑ (Specify:) �.icL�t��G>(SCr3Wte 9/ [;t a-- I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: b y 1,) � M O — �,� ^ " LIC.NO.: / t Licensee: rrY LC, e(,t, Signatures a a3q (If applicable,enter "exem t"i the lice a number line.) LIC.NO.: 7 Address: �(j �]r y]i. r.) kid Bus.Tel.No.;SQL 776 07d-3 *Per M.G.L. c. I47,s. 57-61,security work requires De�artmefitJoKfVPublic Safety"S"License: AIt.L c.No. �S?3J c(gd 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ I