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Home My WebLink AboutBlde-21-006491 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-006491 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:5/10/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 16 TRUMAN LN Owner or Tenant Robert Begin Telephone No. Owner's Address 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: Renovate basement&garage. 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 30 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 12 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 2 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters 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: (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: TROY R BROWN Licensee: Troy R Brown Signature LIC.NO.: 11372 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 215, N BROOKFIELD MA 015350215 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: $75.00 et6,6 --Cti0(24 ),_t1rr Permit No.! c� 6 9 : �°/ Oc ncy and Fee Checked BOARD OF FIRE PREY NTION REGULATIONS [Rev.1/07] (leave bland:) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Aa work to be performed in acoerdanee with die t Code(Mse).527 CMR 12.tlti 1... (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7 - -a City or Town of: N-M10uJt 4 To the Inspector of Wires: By this application theundersigned g vas notice of his or her intention to perform the electrical work described below. Location(Street Number) b i i? OeM l�s v Owner or Ten at j yu F ; ►t� Telephone No. `l 1 ') [,Li ,4 1,56 � Owner's Address 5 Orrikk ,Th4 Is this permit In conjunction with a building permit? Yes EY No ❑ (Check Appropriate Box) Purpose of Building Q Ai 1 itw,(�� LL Utility Authorization No. Existing Service I VO 13,(3 I d 4 0 Afolls Overhead❑" Undgrd 0 No.of Meters 1 • .. New Service 9,u0 Amps lab i d4OVolb Overhead C' Uadgri 0 No.of Meters .1___ Number of Feeders and Ampadty Location and Nature of Proposed Electrical Woric ,�,loorA2-1,. rb V G1 S„,nti-,, -„ c,, Q tg VI Convictionof followingt 0.of be waived bar the I7ec*rof Wires. TetaT kNo.of Recessed lassinakes No.of Ce11.-Swap(Pane)Fans Transformers KVA t No.of Luminaire Outlets No.ofHot Tubs Generators KVA Above Ice- NO.of Emergency 1 No.of Umbels* as Swimmhng Pool tared. ❑ grid. ❑ Una No.of Receptacle Outlets 3 Q No.of 011 Burners FIRE ALARMS No.of Zones T Detection and els No.of Switches 1 No.of Gas Burners Na ofInitiating Devices 11$ No.of Ranges No.of Air Coed. T ns No.of Alerting Devices No.of Waste Disposers >�. l�ia Toes I De oalai ed 11 a ,: . Devices No.of Dishwashers Space/Area Heating KW Loud❑ M ' : ' 0 Other No.of Dryers IHeating Appliances KW Security •* No.of or Equivalent No.of Water KW —No.or No.of Data : , Heaters Signs Ballasts No.of Devices or ' , n No. Bathtubs No.of Motors Total HP T ; , HydromassageNo.of Devices tn. „ , OTHER: Attach additional detail rtiesiret4 or as required by the Inspector of Wires. Estimated Value of Electrical Work (When required by municipal policy.) Work to star a '1- Q n Inspections to be requested in se oe with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issueunless the licensee provides proof of liability insurance including"completedoperation"coverage or� equivalent. The undersigned certifies that such cov- _+•is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE IN BOND ❑ OTHER 0 (Specify:) I care,slide the Albs mad pastilles repe4wy,that he information are this application a true and complete. FIRM NAME: (c ELz c-titL (.o LIC.NO.: 4 11 3-1 Ucellsee: -Tit. q)12e..v • Signature ' MI LIC.Nor: (Ifapplfaable, , +-. - "in theme nronb r lb ) Bus.Tel.No.: S OF, 1 IA 3 )C-s Address: 6 9 1.'1 v1.rn fit o t oc ' -- O 15 j Alt Tel.No.: *Per M.G.L.c.147,s. -61,security work requires a-, ,<„;-„ of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability instance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent Owner/Signature Telephone No. I PERMIT FEE:$ '7 s