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Home My WebLink AboutBLDE-21-001478 Commonwealth of Official Use Only t` , Massachusetts Permit No. BLDE-21-001478 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:9/22/2020 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) 10 ELMCROFT WAY Owner or Tenant OBRYAN PAUL M JR Telephone No. Owner's Address BLECKINGER-OBRYAN JOANNE C, 10 ELMCROFT WAY,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) t/ Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No. .4%. ,,. New Service Amps Volts Overhead 0 Undgrd 0 No of ers 4,sz jhkilligeff Number of Feeders and Ampacity `` ,r Location and Nature of Proposed Electrical Work: Bond &wire pool. . "1_ t a Completion of the following table may be waived b 'i . 1 es. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of ,�i Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA 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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices ns 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:* y No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: y g 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:$85.00 4_1 ootooao qyzyA0 ,ke '1"-2-o-r_tl 4 C4j,( (i (s/ZG 1- aitC ( tl-um)t1JG t‘Y2-0,/7o e lf Official Use On o�nmonwaa Elt o cu�ac cuaEE� _ 75"}"- ( rP cc� Permit No. C —` -- ` W ! ' . 2epartrnani of.ire .ervicai " �� ' ':e Occupancy and Fee Checked 'fi 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: ‘SE/Or A/ 20 zo City or Town of:YAROMINIMINGEM 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) /d A-Z-/I1 Cie ci- Owner or Tenant ,SNOtc) Telephone No. Owner's Address .S%t'mr— Is this permit in conjunction with a building permit? Yes 14, No ❑ (Check Appropriate Box) Purpose of Building e70 Utility Authorization No. Existing Service /ALA Amps /A0 /k/O Volts Overhead L - Undgrd ❑ No.of Meters / New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity 3 41, /eo A` Location and Nature of Proposed Electrical Work: ad/1/P Vc h)/4'l Pod L 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 Ab ❑ In- No.of Emergency Lighting No.of Luminaires Swimming Pool gm ove grnd.wak, 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 Tons No.of Alerting Devices 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 ni❑ Municipal ❑ 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 Value of Electrical Work: 3&0o (When required by municipal policy.) Work to Start:t r 2/ 20.2tispections 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 k BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and pen34ies of perjury, that the information on this application is true and complete. FIRM NAME: L///¢ie Aeabil Eke 77e)C.//;1 LIC.NO.: 3o70 gt Licensee: 1I7 1U A/ Signature p£/4/Lt /Lpt(/y1/ LIC.NO.: (If applicable,enter/exempt in the license number ne.) Bus.Tel.No.: Address: .30 L./177/Ap/G,C, cr I ei1/7 241J/( /)M' a, - Alt.Tel.No.:. -2o,/ 7763 *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: $