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Home My WebLink AboutBLDE-23-005190 OIa_ Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-005190 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:3/21/2023 / _' City or Town of: YARMOUTH To the Inspector of W `-' leer By this application the undersigned gives notice of his or her intention to perform the electrical work described below. d ti l < (,Q` Location(Street&Number) 2 NASHOBA LN " '` Owner or Tenant WILLOUGHBY ELEANOR M Telephone No. Owner's Address 2 NASHOBA LN, YARMOUTH PORT, MA 02675-2046 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 ❑ 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: Replacement heating system. 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 Initiatine 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 ❑ (Specify:) 1 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 Only Commonwealth of Massachusetts Official Use�,� s iiw s° Department of Fire Services Pernm ". COY tr ti I Occupancy and Fee Checked '{' BOARD OF FIRE PREVENTION REGULATIONS �v�'. [Rev.905) C.eate':Iank, APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance.with the Massachusetts Electrical Code(\MEC).527 t.'\!R 12.00 (PLEASE PRINT LV INK OR TYPE ALL I.\FORMATiON) Date: -- ii_d-3 City or Town of: �t1 OV'.-{,, To the Inspector of Wires: By this application the undersigne mikes notice of nis or her intention to perform the electrical work described below.G Location(Street&Number)y�� of f 6r,, ,, C l00 Owner or Tenant f7'11-►tr WC LLoUc KL f� Telephone No. 3b 7-0 b5fp Owner's Address (J 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 Meters I New Service Amps / Volts Overhead❑ Cndgrd❑ No.of Meters Number of Feeders and Ampacit Location and Nature of Proposed Electrical Work: we e}q sy Co»tpletioit,r?he lollowingrable may Ec rained he the Ins error of rl'ires otal No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Transformers KVA K\'A No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above r In- O.of Emergence Lighting ' No.of Luminaires swimming Pool grnd. 1-- grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones I, No.of Switches No.of Gas Burners No.of Detection and �S [nitiatlnA Devices Total No.of Ranges No.of Air Cond. Ton, IkNo.of Alerting Devices No.of Waste Disposers Heat Pump Number'Pons KW (No.of Self-Contained P Totals: l Detection/Alerting Devices No.of Dishwashers S ace/Area Heating K\\" ,Local �lunicipal Other P g Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water rNo.of • No.of Data Wiring: Heaters KW Ballasts No.of Des-ices or Equivalent a Bathtubs No.of Motors Total HP Telecommunications Wiring: No.Hydromassa g No.of Devices or Equivalent OTHER: .Aroch addirianal derail if desired.or as required by rho Inspector of n'ins. Estimated Value of Electrical Work: (When required by municipal policy., Work to Start: Inspections to be requested in accordance with\iEC Rule 10.and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for tyre performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation'.cot erage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the mit issuing office. CHECK ONE: INSURANCE ❑ BOND OTHER ❑ (Specie\:1 f.{Fi/0t�rf:1 wailers-comp 4-aS-d-3 I certify,under the pains and penalties ofperjury,that the information on this applieaft'bn is true and complete. FIRMNANIE: g+rid j)" k) LIC.NO.: I j( ', Licensee: �j (� bv.e.n. Signaturq 1.IC.NO.: 37 Ilf applicable.a c "exempt',(n fhe ice rse t et ther line t Bus.Tel.No.: 7 0 Address: � O V �(� Alt.Tel.No.:SIJ 737(11„p *Security System Contractor License required for this wo tf applicable.enter the license number here: 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 0 owner's agent. Owner/Agent Signature Telephone No._ l PERMIT FEE:$