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Home My WebLink AboutBLDE-22-005752 w Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-005752 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked f Rev.1/07j APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 C 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:4/8/2022 4›.. City of Town of: YARMOUTH To the Inspector of W V �� By this application the undersigned gives notice of his or her intention to perform the electrical work described below. i�") Location(Street&Number) 154 DIANE AVE 1J'1-4 ff"6 Owner or Tenant Bill Rodgers Telephone No.6�t, � J� Owner's Address 4/1Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropria 0 :� Purpose of Building Utility Authorization No. Se' , Existing Service Amps Volts Overhead 0 Undgrd 0 No. New Service Amps Volts Overhead 0 Undgrd 0 No.of MC a 2. Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement HVAC 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. 1 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tots KW `No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 Eauivalent 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. CERMIT FEE:$50.00 �p�// CommotcweaC h o fj'n �a_x /t/asaac�iueetts Official Use Only "�e.,,,,_2„-: n a•trraent o {, �7Permit No./� .}ire _ ervices r BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev. 1/07] leave blank) 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 L INF R ATION) Date: City or Town of: i 0 To the Inspector of Wires: By this application the undersigne gives notice of 's o her intention to perform the electrical work described below. Location(Street&Number) t S Li V Owner or Tenant _ Owner's Address Telephone No. q7 - 6“i •- !la Is this permit in conjunction with a building permit? Yes n No Li (Check Appropriate Box) Purpose of Building Utility Authorization 'No. Existing Service Amps / Volts Overhead L:ndgrd No.of Meters New Service Amps / —Volts Overhead 1 I Undgrd Number of Feeders and Ampacity g No.of Meters Location and Nature of Proposed Electrical Work: Completion of the followingtable may be waived by the In.wector 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 INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers —Eat Pump Number Tons KW 'No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No. No.of Devices or Equivalent Heaters KW Data Wiring: Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP e'1`Tecomrnumcations firing: 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: 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: INSURANCE BOND0 (Specify:) Li&/tl)lGjscoKte 8,t f? �� 0 OTHER I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: 31(O� r� LIC.NO.: Licensee: c L .t? _ Signature (If applicable,enter "exempt"..iv the licen a number line.) _ LIC.NO.: 777 6-7Address: ��3,4 r nl. r• pAd el.No.:Bus.Tel.No.• 7 3 Ili 06 *Per M.G.L. C. 147,s. 57-61,security work requires Deartmelit of Public Safety"S"License: Alt.Lic.No. 7�7 '14c>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)0 owner [i owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $