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Home My WebLink AboutBLDE-23-002700 ,. Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-002700 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:11/15/2022 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) 45 LOWER BROOK RD Owner or Tenant BRETT WHITHURST Telephone No. Owner's Address 45 LOWER BROOK 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: Bedroom addition Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 6 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 4 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges 1 No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 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: BRYANT K DUNDON Licensee: Bryant K Dundon Signature LIC.NO.: 53109 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:67 TAURUS DR, MASHPEE MA 026493458 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 k' / / -6/71 Ai / RECEIVED- ., F. t t ;'t NOV .___.,.__. <...... o aGt/u 7 /tlaeeachueafle Official Use Only t YR;, 15 202n 2 �• h s ar of o��j,a Seri/kid Permit No. `� .p — ,,,i, .YJiLu...._ _� 7i�IRiz7P EVENTION REGULATIONS Occupancy and Fee Checked [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) City or Town of: Date: /0 — /-= z� By this application the undersigned gives notice ntion to perform the Inspectorhe of Wirsdescribed Location(Street&Numbe ) L _ below. Owner or Tenant / ,--z,c---/ Owner's Address elephone No. 77 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building ( Utility Authorization No.Existing Service /u a Amps p /1.2__-_/zYa Volts Overhead/El Undgrd El No.of Meters ` Ne----S- Ce Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity 3 Location and Nature of Proposed Electrical Work: a� "17— (Paddle)i I. Completion o the °flown?:table m be waived b the bts.ector o Wires. No.of Recessed Luminaires No.of Ceil.-Susp. `o.o p )Fans ota t No.of Luminaire Outlets Transformers KVA '--`a No.of Hot Tubs No.of Luminaires Generators KVA Swimming Pool ,rnd e ❑ n- 'o.o mergency g tug No.of Receptacle Outlets - nd. ❑ Butte Units ` No.of Oil Burners •-• FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners `o.o I etection an, No.of Ranges Initiatin 1 Devices No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers 'eat 'ump `urn,er ors Totals: ... o.o e - onta ne No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW Local❑ v un cipa No.of Dryers Heating Appliances ecun Connection ❑ Other `o.o "a er KW yevices `o.o No.of Devices or E,uivalent Heaters ' ° ° Data Wiring: Si ns Ballasts No.of Devices or E.uivalent No.Hydromassage Bathtubs No.of Motors a ecommun ca•ors " rrng Total HP OTHER: No.of Devices or E,uivalent 7�j Attach additional detail ifdesired or as required by the Inspector of Wires. Estimated Value of Electrical Work: /,j �a Work to Start:_ ' (When required by municipal policy.) 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 ( BOND ❑ OTHER I cert fy,under the pain and e1nalties perjury,that the information on this application is true and complete. FIRM NAME: n Licensee: LIC.NO.: /d (If oplicable,eater"exempt"in the license number line.) Signature _�, LIC.NO.: a Address: 7 % i� Bus.Tel.No.:.,� moo' Alt.Tel.No. seer M.G.L.c ld 57-61 �z e / 7 � , •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 one below,1 hereby waive this requirement. I am the(check Owner/Agent ❑owner I owner's a-ent. Signature Telephone No. PERMIT FEE:$