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Home My WebLink AboutBLDE-22-006891 , a.- Commonwealth of Official Use Only ft.ft. Massachusetts Permit No. BLDE-22-006891 ' 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:5/30/2022 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) 27 CROWES PURCHASE Owner or Tenant Russ Aubrey Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No ❑ (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: Septic pump&alarm. 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 Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 1 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 Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 1 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 ❑ 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: 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 ►� �.� � 3 v7i __ `,, E C E I V o 4 nweaLth ol c dachuee Official Use Only Permit No. ZZ G(� 4_ cc77 ep rimed of ire Serviced 9 Occupancy and Fee Checked I E 'REVENTION REGULATIONS _ [Rev. 1/07] (leave blank) A '' E-' -_• - 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/-� l� -2 t a2 p v�aq City or Town of: �,immozi 7— To the Inspector/ of Wires: By this application the undersigned'gives notice of his or her ,�t intention LA perform the electrical work described below. Location(Street&Number) 7 G AL'& .s ✓ r s6 , 1 iv Owner or Tenant �� SS A ce If // Telephone No. V Owner's Address L5/ 1'1L / Is this permit in conjunction with a buildin ermit? Yes '0 No ❑ (Check Appropriate Box) Purpose of Buildings 5E, O7 c �� If?1.9,/Utility Authorization No. Existing Service `d9 Amps liold/. Volts Overhead E Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity 3") /e.Q Location and Nature of Proposed Electrical Work: a v .*.--- 571-7C. gp 1pd /1///evil 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 INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices _ Tot No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number !Tons I KW No.of Self-Contained Totals: r Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Conn Munici ectp ialo n ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent 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 lectr' al Work: //45 (When required by municipal policy.) Work to Start:.5 p Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OV GE: 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 :' BOND ❑ OTHER ❑ (Specify:) p fY:) I certify, under the pains and D enalties ofpe�rj perjury, hat theinformation on this application is true and complete. FIRM NAME: f/ Q r�l/ LpG /0/ d0?o i. LIC.NO. Licensee: L Signature (If applicable, enter "ex}m t"in t e license number line.) LIC.NO.: Address: 0 G�/17E,/�' C ,,P—�,��,J d Bus.Tel.No.: *Per M.G. . 147, s.57-61,security work requires Department of Public Safety"S, Alt.Tel.No:L'�C7l� JI�776, 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)❑owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ I