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Home My WebLink AboutBLDE-22-005748 Commonwealth of Official Use Only 1.1% Massachusetts Permit No. BLDE-22-005748 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:4/8/2022 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) 28 TOWN BROOK RD Owner or Tenant KELLEY RICHARD M Telephone No. Owner's Address 1334 MAIN ST, BREWSTER, MA 02631 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: Replace meter socket 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 krnd. 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 No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 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 Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs 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 ❑ (Specify:) I certify,under the pains and penalties of perjuty,that the information on this application is true and complete. FIRM NAME: Jock E Crewe Licensee: Jock E Crewe Signature LIC.NO.: 32095 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:24 LAKEVIEW DR, SANDWICH MA 025632507 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 RECE_ .v__E° '' PR 0 7 2022 ,nui .0/ a ac Official Use Only , 1, „ c {� Permit No. 027--.S-74t3 U I's art?nunt o _tiro eftliC 4 '+ ^� ��l G DEPARTMEN P 1� - Occupancy and Fee Checked .. •• - 1---- P -E 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: V7/da City or Town of: V,o,n4r7os 11i To the Inspector of Wires: I By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) a iN1v p/aa 2, go/. , ,k51 YAanwt , /i 6.2413 ' 1 Owner or Tenant le C tec '4C/lii Telephone No. ,jd}�''. 6—"t ti Owner's Address /33(f /l4,w St. , �Vnw o te,, i Y✓llt i 0263 l £ Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) �S Purpose of Building ReSteitra,1,a/ /4, c- Utility Authorization No. CI Y: Existing Service /00 Amps /a(3 / 1.lO,Volts Overhead Ff Undgrd E No.of Meters t New Service Amps / Volts Overhead 0 Undgrd E No.of Meters VNumber of Feeders and Ampacity ) Location and Nature of Proposed Electrical Work: $6e Re, (ate 1m-af ctr, / Completion of the followingtable may be waived by the Inspector of Wires, No.of Recessed Luminaires No.of Ceil.-Sas p.(Paddle)Fans No.of Transformers KVA Total No.of Luminaire Outlets No.of Hot Tubs Generators ICVA No.of Luminaires Swimming Pool Above ❑ In- ❑ NO.of emergency Lighting trod. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones ofnd No.of Switches No.of Gas Burners No. Initiatinng Detegon Devices Ines No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump'Number Tons KW No.of Self-Contained H Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal 0 Other Connection No.of Dryers Heating Appliances KW Security S stems:' No.of Devices or Equivalent No.of Water , No.of No.ofKData WIring: Heaters Signs Ballasts No.of Devices or ecommunicatiBattery Un No.Hydromassage Bathtubs No.of Motors Total HP Tel 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: y/� i Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 TS# BOND ❑ OTHER 0 (Specify:) !certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: ,....)4.44, CKCti . Signature 4....C,/^N LIC.NO.: 3yc$15 E /If applicable,enter"exempt"in the license n1umber line. Bus.TeL No.: .5 z5-77(-5 93 Address: 2y LAk€+�t f w ISR ?ndw.s4, 10i l 0203 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No.