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Home My WebLink AboutBLDE-23-005025 #14 Commonwealth of Official Use Only E7 k tP) Massachusetts Permit No. BLDE-23-005025 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•3/13/2023 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her int tion to perfo the electrical work described below. Location(Street&Number) 481 BUCK ISLAND D UNIT 14 Owner or Tenant BUCK ISLAND VILLAGE ASS Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropripte B tx) Purpose of Building Utility Authorization No. 'gyp 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: Replacement conduit between Bldg. 14& 15. 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 •IKVA 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 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 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 ❑ (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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $80.00 _ Commonwealth of Massachusetts i Oft1cial Use Only --' h L3 -Sm2-..� < Department of Fire Services Pe`mt` °. __ s i Occupancy and Fee Chocked , ' BOARD OF FIRE PREVENTION REGULATIONS If Rev.9051 • l:eaie gankl APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ali work to be performed in acccrdancc n ith the V assaehusett>Electrical Cede(>IEC).5"C\IR 12.00 (PLEASE PRINT L\'INK OR TYPE ALLI.VFOR.fIr1TJ(I0,.V Date: 3 -7- 2-3 City or Town of: �G(,I'VYI6 V�7/ To the Inspector of Wires: By this application the undersigned gi es notice of his or her irtention pet n the electrical work descphed below. c OwLocation at Number) i V5 1 el I� Qbe I r`Ynu i5{ Owner or Tenant U� elephon�. Owner's Address cSA4ju.e-- 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 New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: j n 5-tll llA e IPA CdYlt,Vs_ 6,,f ;we 1({ h I S. -('D re LfPd I te.A u�' +n fe ja ie Completion of the lelkme irtg iii/,c may he waived hr the br c ecru of t t'irec. Total No.of Recessed Luminaires No.of Ceil.Sus (Paddle)Fans No.ns KVA P' Transformers KYA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above in- No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. C grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1o.of Detection and Initiating Devices Totallo.of Ranges No.of Air Cond. Tons No.of Alerting Devices Disposers Heat Pump Number Tons K\\ No.of Self-Contained No,of Waste Dis P i Totals:I Detection/Alerting Devices No.of Dishwashers^ Space/Area Heating KW Local❑Municipal E Other Connection No.of Dryers floating Appliances KW Security Systems:* No.of besices or Equivalent .•5 'Water KWNo.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent c Bathtubs No.of Motors Total HP Telecommunications\\icing: No.Hydromassa g No.of Devices or Equivalent OTHER: Attach additional detail if desired,or tt ,rqui"c'd by the Inspector of ll7rtc Estimated Value of Electrical Work: (When required by municipal policy.) \\-ork to Start: Inspections to be requested in accordance with\IEC Rule 10.and upon completion. INSURANCE COVERAGE: Unless waives by the owner.no permit for Me performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The ❑rdersigncd certifies that such coseraee is in fn'ec,and has exhibited proof of same to the limit issuing office. CHECK ONE: INSURANCE ❑ BOND (OTHER 0 (Specify:) (ia.hx.(t waiters comp g—as- .3 I certify,under the pains and penalties ofperjur3•,that the information on this appli t nn is true and complete. FIRM NAME: g'L( ',coLIC.NO.: 13!(Qj Licensee: 4 IG Q(4LN- Signatures -- L1C.NO.: 37 'I/applicable.a er'•ere•nmt ,(n a roe roe r ae the,lint-0 Bus.Tel.No.:j GV 77Ai D 33 Address: '7.IL) W( Pc741V .yQ( Alt.Tel.No.:;5(5‘ 737*4? *Security System Contractor License required tort wo if applicable.enter the license number here: OWNER'S INSURANCE WAIVER: I ant 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 and the(check one,❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:S