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Home My WebLink AboutBLDE-21-007105 Commonwealth of Official Use Only fill% Permit No. BLDE-21-007105 Massachusetts 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) D ate:6/7/2021 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) 486 ROUTE 6A Owner or Tenant RYA► ii ,a ._ .r:J Telephone No. Owner's Address " X1':6 ROUTE 6A,YARMOUTH PORT, MA 02675 Is this permit in con • c on with a building permit? Yes 0 No 0 (Check Approp iate Box) Purpose of Building Utility Authorization No. 0 Existing Service Amps Volts Overhead 0 Undgrd 0 :. 1 4> 49 New Service Amps Volts Overhead 0 Undgrd 0 f Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Bond&wire pool. 0 Completion of the following table may be t • th �e .f• Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of p,, Transformers 'A No.of Luminaire Outlets No.of Hot Tubs Generators `; A 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 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 Totals: Detection/Alerting 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 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: 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 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 C0691A6 41 Gum 4)o alailt ( 10 POQauAD1?k 1.13/74 M J f e (Mo earea ai<,t ) s((c ( 4 tie____ '+ •` //�� I�// '14 / Official Use Only" ,. Commonwealth of!//w.lachuuelt-t r7( O (� n - y� � (fit ( J a�� cc�� '�'77'' n Permit No. _.jet .L'oparbnenl o/.. ire &r,iceJ =;;;r Occupancy and Fee Checked ;°._-:J-r BOARD OF FIRE PREVENTION REGULATIONS (Rev 1ro71 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ___.� All work to be performed in accordance with the Massachusetts Electrical de(MEC),527 CMR 12.00 71 7 ---`v--(ki. SE PRINT IN INK OR TYPE ALL INFORMATION) Date: Gl Ale 7 ?Oaf 3 ` - City or Town of0To the Inspector of Wires: '' B)' 's application the undersigned gives notice of his or/ her intention to perform the electrical work described below. ` Location(Street&Number) ,4L 8C O�'D !`/N6'S 14y& 6A YA 12moum PO kr "� -, Ow# r or Tenant C AL IV DU Telephone No. 1 t j ' "' ,�w is Address L "'— '"B. this permit in conjunction with a building permit? Yes $. No ❑ (Check Appropriate Box) Purpose of Building TOO L,. Utility Authorization No. Existing Service ?OO Amps I 2O/2-VOVolts Overhead Cfi'Undgrd ❑ No.of Meters l New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity 3 OHO O �4- Location and Nature of Proposed Electrical Work: 30 1\)P -t Gtr IRE— PO O 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 0 In- M 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 Initiating Devices No.of Ranges No.of Air Cond. on No.of Alerting Devices No.of Waste Disposers Heat Pump Nunt¢et_,__Tong_i_KW__ No.of Self-Contained Totals: Detection/Alerting 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 Equivalent No.of Water No.of No.of Data Wiring: Heaters KW 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 Valu;of Electrical Work: jOOO (When required by municipal policy.) Work to Start: b-7-11 Inspections 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 titlBOND ❑ OTHER ❑ (Specify:) I certify,under the pr and penal ' s of perjury,that the information on this applic, ion is true and complete. FIRM NAME: Z RO&� �1ey. '1C1 4- LIC.NO.: 3 070 8 e Licensee: _ '.• • # Signature gaga i i i _.Ai e.... LIC.NO.: (If applicable,enter//'exempt"in the license number lin / Bus.Tel.No.: Address: 3o L.I yri E RLGIG GT- 41 fl2i#- O2632lt.Tel.No.: SO 8 -.3,071 --06/ *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. 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) 0 owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $