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Home My WebLink AboutBLDE-22-006014 Commonwealth of Official Use Only I --: .,'., Massachusetts Permit No. BLDE-22-006014 .4......... BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.I/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:4/20/2022 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) 63 POMPANO RD Owner or Tenant Brian McMachan Telephone No. Owner's Address 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: Remodel kitchen&bath room. 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 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection 0 Other: 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Donald R Lowe Licensee: Donald R Lowe Signature LIC.NO.: 34271 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:407 W WASHINGTON ST, HANSON MA 023411020 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 c')-- (:)-v-celf (1(7A (1-2---Kg- / ' --. ( f) N 1p____0114b-- RECEIVE ® "it' aa`` APR 19 20§0 nw a[th o/Maeaachu4al6 Official Use Only Rim c� nPermit No. eZ-72--6,0( Le '� r ILDING DE PAIR ,q,/° ,ti at°�,}i"Jorvic" "� Occupancy and Fee Checked o ; ` '. - -=�BeA�=OF-€RE PJ EVENTION 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: 41 / /q 1.A City or Town of: YARMOUTH To the Inspector of Wires: kr By this application the undersigned giv s notichof his or in intention to perform the electrical work described below. "--- Location(Street&Number) 60 Y1'1 ' Gt h/ O rt k,✓lc4 t' kvl t> ((n 1) Owner or Tenant f�,v� .)- Y� 5 r � r < �Yi L he,tl Telephone No. 7 $/- g L((i_.2SG 7 1 Owner's Address j(f l- VII -e- f,. ,..31 Is this permit in conjuncts n with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building HG Wl ,e Utility Authorization No. Existing Service/ 00 Amps / Volts Overhead❑ Undgrd❑ No.of Meters v New Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters 1 Number of Feeders and Ampacity • 6: Location and Nature of Proposed Electrical Work: fr Completion of the following table may be waived by the Ins ector of Wires. .14, q,, No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA '=;t No.of Luminaire Outlets No.of Hot Tubs Generators KVA t'. No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting _grad. 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 ° No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number TonsW No.of Self-Contained Totals: '" Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal ❑ Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data WIring: 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: (When required by municipal policy.) Work to Start: 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 0 BOND 0 OTHER 0 (Specify:) I certify,under the pjd and penalties of perjury,that the information on this application is true and complete.' r FIRM NAME. /�%➢�"/1 it .O Ore- LIC.NO.:3`-! )1 ( �� Licensee: �/ Gill'-'--- Signature 0,4144� — LIC.NO.: (If applicable, rater' empt"in the lice,}se numb r line.) Bus.Tel.No.: ci 3 3 l Address: t' V/'WASh I a Lol r > h(ti ii ✓'^-- Alt.Tel.No.: 31 - ^ 1 *Per M.G.L.c. 147,s.57-61,security worlerequires 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. 1 PERMIT FEE: $ c� Lts-nikt6 1-1-646' FiKrocks CE'114m7- MI)eivr L L