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Home My WebLink AboutBlde-21-006490 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-006490 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: Kitchen renovations Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 7 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 6 No.of Gas Burners No.of Detection and Initiatini=-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 1 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 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 I 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 ❑ 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: $75.00 1$. (la 57116l2A i - -, Permit No. ' 2c -Cp Le 6t v OF FIRE PREVENTION LATIONScr and Fee Checked & ' AeaNe APPLICATIONBOARD FOR PERMIT TOREGU PERFORM EliffILECTRICA) L. WORK jAll work S be performed in accordance with theme Electoral Code(MEC),527 CAR 12.00(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: d 1 1� ( s s a A City or Town efi o- tA Ta the Ins for a 'Wrres: By this applies the un d g v ds notice of his or her iaato perform the electrical work d below. Location(Street& ) l b T1,t '1-Pr Owner or Tenant r 1 Telephone No. '11 y 'b't 4666 NO' Owner's Address ' 4-yv1 (�1 ' Is this permit in conjunction with a ramiCr Yes No 0 (Check Appropriate Box) t Purpose of Building 4yt,,,,v.� Only Authorization No. Service 1 1/0 Amps IN,/}'b Veld Overhead Undgrd 0 No.of Meters U New Service Amps / Volb Overhead 0 Undgrd 0 No.of Meters Number of Feeders and AapaHy I Location and Saturn of Proposed Bieetrieail Week: Ka C. v._ v..,,,,,,„,,...,1„.--, .. Cosgl j he,��iable nay be ad by the I of I es. er Total kOf. No. Ln of of Recessed abres I No. Celt-Saw.(Paddle)Fansa Transformers KVA No.of L nminaire Outlets No.of Tubs Generators KVAAbov . upting No.oft res a swimming Pod wad. ❑ m In- Q rto.of nmagency frail. aced. Battery Unite No.of R Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of 6 No.of Gm Bunten No. DevicesInitiating otal tU No.of Ranges No.of Air Curd. T Tons INo.of Alerting Devises No.et Waste Disposers Heat o Nattier Tom 3CW Seif�on No.off I Space/Area Heating KW Leas 0 ' 0 air No.of Dryers Heating Appliances KW ofSl�or Univalent 'No.of Water KW Ne.of No.of Bea Wig: Beaten Silos Ballasts No.of Deviate or No.Hydromassege Bedaubs No.of Motors Total HP T elecomatankationsC No.of Devices or OTHER: Attach atkiiitetaldetail fdesireti or as reed by the Inspector of Estimated Value of Electrical Work (When required ed by municipal policy.) Work to Start a 'L t 11 Inspections to be requested in accordance with MEC Rule IQ,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance e of electrical work may issue unless the licensee provides proof of liability insurance including"complied operation„coverage or its substantial equivalent. The ' undersigned certifies that such is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE INSURANCE a 0 0 (Specify* iteraWit nadetlrepaits and pailie,ifpeslary,what the infer Nrti a en this application Is hue and co complete. FIRM NAME: V)(a.�.. e idc,. a i' LIC.NO.: 14 t ( 37�.. G,vI _A 7 . -•- LIC_NO.: °gyp "� WA aa tt b fl'la '>t�3`i Bus.lLTelNo.; ob '169 ,?76 *Per M.G.L.c. 147,s. 7-b1,security work requires D of Public Safety"S"License: A�Tel No.o. 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)❑owner Q owner's agent. Signature Telephone No. I PERMIT FEE:$ ' 6