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Home My WebLink AboutE-20-395 -- Commonwealth of Official Use Only illMassachusetts Permit No. BLDE-20-000395 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:7/24/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her mtenh n to perform the ectncal work described below. Location(Street&Number) 112 ROUTE 6A D( 24vt A,-Q Owner or Tenant I I j lbo PAU Telephone No. Owner's Address 12 ROUTE 6A,YARMOUTH PORT, MA 02675 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 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: In-ground pool. 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 No.of Detection and Initiatinc 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/Alertine 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 Data Wiring: Heaters Siens Ballasts 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: Lawrence R Brown Licensee: Lawrence R Brown Signature LIC.NO.: 30708 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 LIMERICK CT,CENTERVILLE MA 026322713 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 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: $85.00 (144-0VOVAT6 7/2461 7FAI)/9(---60i_ .4c;1,t44, oit,..t) 0(1119 //.. ._ c'9t Pkio 1,0tiet.no tevio ei,/t/ Lf ' Commonwealth o/ /r/ailachu.settj Official] Use Only G—c 3st CJ cc�� nn Permit No. .L'eparbnent o��ira JeruicaJ Q-1-1-7)� FS'„�\Occupancy and Fee Checked (� BOARD OF FIRE PREVENTION REGULATIONS (Rev.1/07] (leave blank) ma APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C e( EC).527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALyL�IINFORMATION) Date: cu/f a 3 .20/9 City or Town of:YAMP To the Inspector of Wires: By this application the undersigned gives notice o his or her intention to perform the electrical work described below. Location(Street&Number)/ 1/ I O u*e 6 A L Owner or Tenant ,4W DE.,9rnrn/,4A v Telephone No. O0 Owner's Address SAME-- ‘. ..' - Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) r40,„ Purpose of Building 'O0 Utility Authorization No. -\t Existing Service (906 Amps /AV olts Overhead❑ Undgrd No.of Meters / =� New Service Amps '-7/ Volts Overhead 0 Undgrd El No.of Meters Number of Feeders and Ampacity 3 IX 90o f, Location and Nature of Proposed Electrical Work:�QA)2) fi It I R� P00 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 Ab ❑ In- No.of Emergency Lighting grad.ove gmd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Totalo No.of Alerting Devices No.of Waste Disposers Heat Pump NunIt?et_ __Tarn._ __IOW__ 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 No.of No.of Data Wiring Heaters KW Signs Ballasts 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:(3 () tO O (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RA E: 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 ix BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury, that the information on this application is true and complete. —7 p FIRM NAME: AM C Cc MCC / i✓ �/ 1 ��Y�,7 LIC.NO.: 36 lQ() ^ Licensee: Signature ! . '"- 60°-1 LIC.NO.: (If applicable,enter"eyrmpt"in the license number line. /� Bus.Tel.No.: Address: L.LNf EPdc t� CY regVig°. MA- o 2_632. Alt.Tel.No.: ( 8 I -770 5 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $