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Home My WebLink AboutBLDE-23-002599 #17 Commonwealth of Official Use Only f<0Massachusetts Permit No. BLDE-23-002599 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:11/10/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform t lectncal ork described belpy✓. Location(Street&Number) Ass RD 1 /tF^ .. Owner or Tenant THOMPSON WILLIAM P -�J Telepho e No. Owner's Address BROWN-THOMPSON MICHELLE A, 17 ANGELOS RD, SOUTH YARMOUTH, MA 02664 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: Finish basement 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 20 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 20 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges 1 No.of Air Cond. Total No.of Alerting Devices Ton Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No No.of Devices or Equivalent HeatersWater 1 KW No.of No.of Ballasts Data Wiring: 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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:$75.00 I RECEIVED L NOV 0 9 2022 tyy� BUILDING Db ` •V y �• o`fl.Zzo ac�(ta -t it- •/ By . �.� ... c Official Use Only qq � in Jervkee Permit No. 3-� • t ( �-- BOARD OF FIRE PREVENTION REGULATIONS Occupancy Fee Checked K � APPLICATION FOR PERMIT TO �v.Iro7J ICBVe blank �'"---- All�«*to beaccordance PERFORM ELECTRICAL WORK � !LEASE PRINT IN INK OR TYPE � with the Massachusetts c. I ALL INFORMATION) Electrical Code EC), 27 CMR 1 op City or Town of: Dater �Y this application the uo 3wiler,s ddit e s& dew ARMOUT Henti to To the Inspe for Wires: Nn r) ores the electrical work described below. Owner or Tenant C 15 /� Owner's Address Telephone No, /s this permit In conjunction with ��ng �—�2` r'Pose of Building permit? Yes allo.0 (Check Appropriate Box) pu Existing Service— Amps t Utility Authorization No. Volts Overhead❑ Und �❑ No.of Meters Number of F Amps / Volts Overhead CIUndgrd — eeders and Ampadty ❑ No,of Meters Location and Nature of Prop e, Electrical Work: Lb iVo.of Recessed Luminaires Co--•letM,r o the oil, ; table in,Na of CeLL,Sn (Paddle) waived, the I for o Wires. oi No.of Lnmhutre Outlets �' Fans o.o Transformers KVA IZI Naof Hot Tubs 4' Na of Luminaires Generators Swimmingp CZ* KVA y` No.of Receptacle Outlets d' ❑ ° d. ❑ Batt Unib�ry ' ;mg No.of OB Burners No.of Switches MEM=No.of Zones t,.t ' No.of Gas Burners 'a In Na of Ranges n an, No.of r Cond. o. itiatia Devices Na of Waste Disposers t um Tons No.of Alertin g Devices Na of Db6washers Totals: oas `et o r on n a_ ( Space/Area Heating KW mimw Detection/ a Na of Dryers Local❑ 'mn"" a o ''a ( Heating Appliances Connection 0 other KW ` n No. es No.H Heaters KW °'o s Baol.laoats Data Wiring: f i evl or • ,mivaleat Ydromaasage Bathtubs Na o No.of Motors Total HP a ofman ,; ggRnt OTHERS Na of Devices or • .mivaT ent Estimated Value of Electrical Work: Attach additional derail i Work Start; �• ( � fdesired,or as required by the Inspector of Wires. INSURANCE Inspections to be required by municipal policy.) RANCE COVERAGE; Unless waived byrequested in accordance with MEC Rule 10,and the,licensee provides proof E. Unless liability the owner,no Permit for the upon eompletissu undet9insed certifies insurance including« n coverageoa or electrical work may that such coverage is in force, ��operation" its su issue unless CHECK ONE: INSURANCE 0 BONDexhibited proof of same to thebstantal equivalent The and has I certi,/y,ander the pains and penalties o 0 OTHER permit issuing otiice. FIRM NAME: fpery'my,that the in❑fort n on this nsee: application is true and complete. (If applicable.tee, .. Signature LIC.NO.: Address: exe+rrpt"in the dcense number line. 'Per M.G.L.e. 147,s.57-61, LIC.NO.�� OWNER'S INSURANCE security work Bus.TeL No.• — --._._ rRANCE WAIVER: I am aware Department of Public Safety~S••License: Mt.TeL No.: Ow required by + that the Licensee does not have the liabilityLic.No. to below,I waive this insurance Signature , - requirement. I am the(ehec. ,ne owner •coverage normally elephone 4�.�pk• 62' owner's a:ont. \ PERt1lIT FEE: ?�-�� c 1 a,3_