HomeMy WebLinkAboutBLDE-22-004944 unit A /1.w1/ Commonwealth of Official Use Only
•L. i Massachusetts Permit No. BLDE-22-004944
` 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:3/8/2022
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) 27 BRIAR CIR
Owner or Tenant Hieu Nguyen Telephone No.
Owner's Address 27 BRIAR CIRCLE, SOUTH YARMOUTH, MA 02664
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: Rewire kitchen&2 bathrooms.Add 28 Ii
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 28 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- ElNo.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets 10 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 8 No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges 1 No.of Air Cond. Ton l No.of Alerting Devices
No.of Waste Disposers 1 Heat Pump Number Tons KW , No.of Self-Contained
Totals: Detection/Alertinn Devices
No.of Dishwashers 1 Space/Area Heating KW Local 0 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 Sinus No.of Devices or Eauivalent
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 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Hien V Tran
Licensee: Hien V Tran Signature LIC.NO.: 50952
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:83 RICHMOND ST,APT 3,DORCHESTER MA 021245729 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
Signat m..
Telephone No. PERMIT FEE: $250.00
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s/ BOARD OF FIRE PREVENTION REGULATIONS Occupancyand
Fee decked
[Rev, 1/07] (leave blank) �—
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)
I City or Town of: YARMOUTH Date:
To the Inspector of Wires:
k13Y this application the undersigned gives notice of his or her intention to . r orm the electrical work described below.
.ocation(Street&Number)
LOwner or Tenant A, A _—.
uwoer's Address L Telephone No:4 . _ _�:r o;s, I6 -
Ia this permit In conjunction with a brei! _-�
ung permit? Yes ,P No 0 (Check Appropriate Box)
purpose of Building____________
f� Utility Authorization No.zisting Service-�LIQ. Amps J Volts Overhead
Undgrd 0 No.of Meters ___2. _
New Service Amps / Volts Overhead
ntpadty Undgrd 0 No.of Meters
Number of Feeders and A
Location and ature of P , , , , Electrical Work: .0rMir ,r
"` ' � / �" '• ami �OtI c;.. �' .Q
Com,leflon o the 'How' : table m' be waived b the I . for o Wires.
U No.of Recessed Luminaires No,of Cil. 'o.o
• -Snap.(Paddle)Faos Transformers Kota
VA
Na of Luminaire Outlets Na of Hot Tubs
.4` Na of Luminaires Generators KVA
Swimming Pool ' ' e n- o.o 'mengency ng
'd. I-1 , ,d. ❑ Butte Units
F No.of Receptacle Outlets No.of OU Burners
c1.: FIRE ALARMS No.of Zones
No.of Switches No.of Gas.Burners `a o r^
ec' ,nan,
Inifiadn Devices
No.of Air Cond.
o
12r
Tons No.of Alerting Devices
No.of Waste Dbposers T otals: •,'um, r ons ' "�_ 'o.o ' on. a ,
up MITI
NO.of Dishwashers Space/Area Heating _.. n/ !Akron Devices
Na of Dryers Local Conn i : 0 Other
o.o Heati
KW 'o.o 'e.ong Appliances KW ty y
Heaters No.of Devices or ' nivalent
No.Hydromassage S, ,a Ballasts Dataa of .
y massage Bathtubs No.of Motors e ., Devices°r 'nhelent
Total HP mown ; ,ns �,
OTHER: Na of Devices or r . -, t
Estimated Value of Electrical Work • Q Attach additional detail(fdesired,or as required by the Ins
Work to Sten (When required by municipal policy.) Factor of Wires.
Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no
the,licensee provides proof of liability « permit for the perfomtence of electrical work may issue unless
undersigned certifies that such i� insuranceforce, completed operation"coverage or its substantial equivalent. The
exhibited proof of same to the
❑ OTHER 0 (S permit issuing office.
CHECK ONE: INSURANCE 0 BOND
I cerdJy,under the pains and penalties o ��')
FIRM NAME: fpeHety.that the injo►tnation on this a�tkallon is true and complete.
Licensee: mgffsigimmerSignature 7' LIC.NO.:
(I applicable,enter ,t the license number line.) , QL�i LIC.NO.: 6 9
Address:d c. 147,s.57-61 recur ',rk ? d' I� '"/ 001 . Bus.Tel.No.• /' -7
'Pei M.G.L.MR'S INSURANCE WAIVER: I requires Department of Public Safety"S"Licen: Alt,Tel.No.: /
am aware that the Licensee does not have the liability insuranceoverage n�
regt}ired by law. By my signature below,I hereby waive this requirement. I am the(check one R owner ,
Signature � � owner's a v ant.
Telephone No. PERMIT FEE:$
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