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Home My WebLink AboutBLDE-22-004794 �, Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-004794 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:2/28/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 699 WILLOW ST Owner or Tenant BROWN RICHARD LEE Telephone No. Owner's Address 23060 WIDGEON PL,CANYON LAKE, CA 92587 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: Septic pump&alarm 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 grad. 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 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 1 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 Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters • Siens No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 1 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 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 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 _ Commonwealth o///Iassachu.6etts Official Use Only It. y Permit No. 2 _ - 79 L\ -�+—. _ eparlin.cnt o f g Scry css -`i- =ar ' Occupancy and Fee Checked _-:., .,r` BOARD OF FIRE PREVENTION REGULATIONS ER"- 1/07] (leave blank) . R E C E I V EVP LICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK - All work to be performed in accordance with the Massachusetts Electrical Code r E S PRINT IN INK OR TYPE ALL INFORMATION) Date: C'(MEC),527 cMR l 2.00 FEB �820 i �3 Z.g zozZ Ity or Town of: YARMOUTH To the Inspector of Wires: BUILDING DEPART /I �P.iication the undersigned gives notice of his or her intention to perform the electrical work described below. eY — Location Street&Number) lD W,L(,.oW sr- So yARMoum Owner'or Tenant F/_,41 -, ER V Telephone Nos('-a6 S- 1 ZOg Owner's Address s4(4' Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building J'TIC W4 O + ILAn PVC, Utility Authorization No. Existing Service /0(� Amps t20/ 11Z Volts Overhead Q!Undgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity 3 to l 00 Location and Nature of Proposed Electrical Work: (.CD f RE- S C '1(C Puw0 + 11 14Q/( 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 ISvtzmmiag Pool Above ❑ In- ❑ {No.of l mergency Lighung rnd. grnd. !No. Units No.of Receptacle Outlets INo.of Oil Burners FIRE ALARMS No.of Zones No.of Switches INo.of Gas Burners No.of Detection and Initiating Devices t No.of Ranges I No.of Air Coad. Tons No.of Alerting Devices • C No.of Waste Disposers IHeat Pump Number Tons KW No,of Self-Contained Totals:I� "F -^-"'�" "'_ DetectiSoet eoltg Devices '.' . No.of Dishwashers Space/Area Heating KW Local Municipal V7 Connection ❑ � c�- No. of Dryers Heating Appliances , Security Systems:* v No. of Water No.of No.of Devices or Equivalent Heaters KWNo.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs INo.of Motors / Total HP / /10 Te1No.of De iaesoor Equivalent OTHER:C), ` V Attach additional detail if desired or as required by the Inspector of Wires. 'i! Estimated Value of Electrical Work: 900 (When required by municipal policy.) Work to Start: 7.--2.$-2 Inspections to be re uested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the wiser,no permit for the performance of electrical work may issue unless Li the licensee provides proof of liability insurance i uding"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in f ce,and has exhibited proof of same to the permit issuing office. Q CHECK ONE: INSURANCE 1231.. BOND 0 OTHER ❑ (Specify:) C I certify, under the pains and penalties o er u that the information on this application is true and complete. P Iry, FIRM NAME: LARR `,ROW/ll Ok0 CTRICJ LIC.NO.: 3 070 E� 0 Licensee: OW/i) Signature .G'1'1 LIC.NO.: (If applicable,enter "exem t"in the license number line.) l 2 Address: (7 () L/�ER/C , C7— CL V7 l uigo �IlL t7232-- Bus.Tel.No.:-s - 7 6 7 J "Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Alt Lic. No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. my signature below,I hereby waive this requirement. I am the(check one)❑ owner 0 owner's a en[. Owner/Agent 01 Signature ',A TeIephone No. PERMIT FEE: $