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Home My WebLink AboutBLDE-21-006171 n , Commonwealth of Official Use Only (1 ,i Massachusetts Permit No. BLDE-21-006171 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:4/26/2021 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) 70 OUT OF BOUNDS DR Owner or Tenant Levy 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: Bonding&wiring of 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- CINo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches 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 I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devics 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 S eci I certify,under the pains andpenalties o (Specify:) fperjury,that the information on this application is true and complete. FIRM NAME: LAWRENCE R BROWN Licensee: Lawrence R Brown Signature LIC.l NO.: 30708 (If applicable,enter"exempt"in the license number line.) Address:30 LIMERICK CT, CENTERVILLE MA 026322713 A . Tel o.:: Alt. *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Tel.No.: 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: $150.00 I C t)—l`gS 'g #42 zx ' a �i c iU6'44 1(z12-r Commonwealth o f�ylamachueetta Official Use Only R /(�� jj --7 ( _ l 2)epartmeni of-ire - ervice9 Permit No. V�� P ( 1 r a Occupancy and Fee Checked ,.`Ioi BOARD OF FIRE PREVENTION REGULATIONS [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) Date: '7 ".RI-1 - 2 1 City or Town of: To the Inspector of Wires: By this application the undersigne of his or her intention to perfo rm rm the electrical work described below. Location(Street&Number) .7() C)LIT 0 F l u tt;i)S -D Owner or Tenant Levy Telephone No. Owner's Address SA1Y1t Is this permit in conjunction with a building permit? Yes No 0 (Check Appropriate Box) Purpose of Building 170-0 Utility Authorization No. Existing Service c 'OOjy Amps )20/2i.t'0 Volts Overhead g• 'nd d � 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd 8t' 0 No.of Meters Number of Feeders and Ampacity J? ie✓ 0 i4 Location and Nature of Proposed Electrical Work: 13 c,h i i) 4" i/ei I P POO L Completion of the following table may be waived by the Inspector of Wires. No. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans f Total No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Ab ln- No.of Emergency Lighting grnove 0 d. gnd 1.4 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 No.of Ranges Total Inifa ' , Devices No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin. Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal+ 0 Other No.of Dryers C. e ri Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or uivalent Heate KW No.of Data Wiring. s :alla N I.o Devices o .uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No. of Devic or . ivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 'd Work to Start: — (When required by municipal policy.) - 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 insurance including "completed d operatiormit for the n"I cove coverage or ts substantial equiance of electrical work valent.issue unlessundersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE g BOND 0 OTHER 0 (S I certify,under the pains and penalties of perjury,that the information on this(Specify:) is true and complete. FIRM NAME: L "+ E7 - / /Ai Licensee: , LIC.NO.: 7 Signatur _____ (If applicable,enter"exempt"in the license number line.) LIC.NO.: Address: - )Li e c7L'/1 ( / Alt.Tel.No.: 3 Bus.Tel.No. L1 y '7 76 Per M.G.L. 7 14 � �� 4 ,s S7 61,security work requires Department OWNER'S INSURANCE WAIVER:I am aware that the ns of doPeslic not have the liability insurance coverage normally required,by law. By my signature below,I hereby waive this requirement. I am the(check qu Owner/Agent one) ❑ owner ❑ owner's agent. Signature Telephone No. PERMIT FEE:$