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Home My WebLink AboutBLDE-22-000945 Commonwealth of Official Use Only Massachusetts MI Permit No. BLDE-22-000945 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:8/18/2021 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) 22 GREENLAND CIR Owner or Tenant David Michalowski Telephone No. Owner's Address 22 GREENLAND CIR,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (CA propriate Box) Purpose of Building Utility Authorization N Existing Service Amps Volts Overhead 0 Undgrd �, �t terse New Service Amps Volts Overhead 0 Undgri J I iiIn..... �jNumber of Feeders and AmpacityG.�Location and Nature of Proposed Electrical Work: Wiring&grounding for pool 84" rCompletion of the following table may , :L , ' Inspector ofWires. P 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 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 Tons 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 Siens 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 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 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: $135.00 t&A-114 611110 Q?.A 6 WaS loop f atpr)u--t T-euvs te(7c(zi p,4_71 d t v q idru)jMG .- /3t�zl q ., t Z I h Q fj/y/ Official Use Only �l= i ornmonwea/, h or aJJac iuettJ E-ZZ�(0 c3 L(S > 1 � - � r f cc�� // Permit No. I b _� .L'eparbnent of--lire —.Cervical 1 r-_ 1 'f i Occupancy and Fee Checked 9! E" 7 ; BOARD OF FIRE PREVENTION REGULATIONS (Rev.Troll (leave blank) cam; J !CATION FOR PERMIT TO PERFORM ELECTRICAL WORK r I- All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR I2.00 (PLEAtE P INT IN INK OR TYPE ALL INFORMATION) Date: Alt? /c9 .2O-2-I ity or Town of:YARMarkWOMIPP To the Inspector of Wires: By this application the undersigned gives noticeot of his or her intention to perform the electrical work described below. Location(Street&Number) a2,- GR L �� C to, /I')!CM1-i3Ou>sk�` -' A-V I Owner or Tenant 7) Telephone No. Owner's Address es GREE--7 /L,4'/77 C/a- Is this permit in conjunction with a building permit? Yes Igi, No ❑ (Check Appropriate Box) Purpose of Building Von L- Utility Authorization No. Existing Service /60 Amps 120 / OVolts Overhead❑ 'ndgrd 0 No.of Meters/ New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity 3 k j /6 o,— Location and Nature of Proposed Electrical Work: D Al D t IA)1 R.E---?on 1--- 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 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 No.of Waste Disposers Heat Pump Nun cr.,__Tons____IOW__ No.of Self-Contained Totals: _ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 gvivalent 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: 3kb 6 (When required by municipal policy.) Work to Start:g-*1 g-2-I 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 ih... BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. .---- FIRM NAME: .4A-Rig f2 0 to E/CG7R /M" LIC.NO.: t307 G r& Licensee: Signatu LIC.NO.: (If applicable,enter;exempt"in the license number line.)/,, Bus.Tel.No.: r, Address: 3O Ai rnEX Lek GT NTERiV e, /,Z�- 0163AAlt.Tel.No.:��0("d)l-??63 *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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $