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Home My WebLink AboutBLDE-23-005818 Commonwealth of Official Use Only ' Massachusetts Permit No. BLDE-23-005818 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:4/20/2023 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) 163 BREEZY POINT RD Owner or Tenant COLENA LORNE B Telephone No. Owner's Address COLENA PAULA M, 3 LENOX DRIVE, FRANKLIN, MA 02038 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 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 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 ❑ 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 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 EE $50.00 f� - -_�- Official Use Only Commonwealth of Massachusetts ��`55 qq i c' 5' V�/; Permit No. -c6([/ Department of Fire Services �.� ' Occupancy and Fee Checked • BOARD OF FIRE PREVENTION REGULATIONS KRei-.9 05] (.ease.,lanki APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All cork to be performed in aecrdavice,c int the\tassachnsetts Electrical Code(MEC).527 CMR 17.00 (PLEASE PRINT IN INK OR TYPE ALL LL IV FOR AT1,O.\) Date: (-17- City or Town of: ya(ll'10(A1 To the Inspector of wires: By this application the undersigned givelnotice of his or her intst lion to}terfomt e electrical work described below. L. Location(Street&Number) l6 irLL` z( 1 o1 V(.{` IC OwnerorTenant j-•QY{1,t✓ LP Telephone No.SA C/34' 9w Owner's Address 5.4 - - ._ _ ---- --_ is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of deters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity , Location and Nature of Proposed Electrical Rork: Wire_ OA c.-CC Cocrpletinrr of-the tollots ing table mar he.,aired!fir the brc•>ector of Hires. 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- O.of Emergency Lighting grnd. C grnd. Batten'Units __ No.of Receptacle Outlets No.of Oil Burners FIRE ALARNIS No.of Zones No.of Switches No.of Gas Burners No. etection ad Infitiating Dicese No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices Heat Pump Number Ions KWNo.of Self-Contained No,of Waste Disposers Totals: Detection/Alcrting,Deices No.of Dishwashers Space/Area Heating KW Local[]1lunicipa Connection Other ,Heating Appliances KW Security Ssstems:* No.of Dryers No.of Devices or Equivalent No.of Water KWNo.of No.of Data Wiring: Heaters Signs Ballasts No.of Deices or EE uisalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsW firing: No.of Deices or Equivalent OTHER: Aitarh icddirional detail if desired,or as reyuit'ea hr the Glspectar of ilirec. Estimated Value of Electrical Work: (When required by municipal policy.i 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'cot erage or its substantial equivalent. The urdersigned certifies that such coverage is in force,and has exhibited proof of same to. per missuing ff�. �l a�_ 3 CHECK ONE: INSURANCE ❑ BOND(CVI, OTHER 0 (S ecify�:1 (.(A�\t JC I certify,tinder the pains and penalties ofpepuiT,that the information on this appii ion is true and c NO.ete t_ r rJ FiR1►NAME: (n) 1 Signatures LIC.NO.: 3� • Licensee: Bus.Tel.No.: 7 (Iiapplicable.a er"eseinot%in e ice Ise r u ther line l Alt.'fet.No.: a Address: d *Security.System Contractor License require for this wo ;if applicable.enter the license number here: �—--- OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liabiliq'insurance cocer<tge normally required by law. By my signature below.I hereby waive this requirement. 1 am the(check PERMIT FEE:�tyner's aaerrt. Owner/Agent Telephone No._______—_____ Signature y •