HomeMy WebLinkAboutBLDE-19-000402 Commonwealth of Official Use Only
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ESA Massachusetts PennitNo. BLDE-19-000402
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.l/071
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Coder(MEC),527 CMR 12.00
(PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date:7/19/2018
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives nonce of his or her intention to perta he electrical work desf rriibbedbelow.
Location(Street&Number) 2 SANDY LN ICktitt P-1-0 !"�t,;, N ,. C Q U4
Owner or Tenant MCLAUGHLIN MAURA F TRS Telephone No.
Owner's Address C/O ANNE FLANNERY, 11 HICKORY LANE,FARMINGTON,CT 06032-1905
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 ❑ 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 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 No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Ab ❑ P-11
n- ❑ No.of Emergency Lighting
grnove d. 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 0 Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters 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: 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: James J Reilly
Licensee: James J Reilly Signature LIC.NO.: 16666
&applicable,enter"exempt"in the license number line.) Bus.TeL No.:
Address:14 NORFOLK AVE,SOUTH EASTON MA 023751907 Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"5"License:
OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But
signature below,I hereby waive this requirement.I am the(check one) 0 owner ❑ owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$75.00
IcR, r 9/x(8
ff 'a Use Only,‘,
t of / Commonwealth of Massachusetts Permit No. k `'"I'Oy_.
E:t llis. @ Department of Fire Services Occupancy and Fee Checked
1"..:.‘d BOARD OF FIRE PREVENTION 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 7.13.18
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) 2 SANDY LANE
Owner or Tenant BEVILACQUA,RICHARD Telephone No:
Owner's Address 4 DELCAR DRIVE,WALPOLE,02801
Is this permit in conjunction with a building permit? Yes No (Check Appropriate Box)
Purpose of Building RESIDENCE Utility Authorization No.
Existing Service Amps Volts Overhead Undgrd No.of Meters
New Service Amps Volts Overhead Undgrd No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work ROUGH AND FINISH OF 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 ICVA
No.of Luminarie Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Agrnbod.ve ❑ In-grnd. ❑ No.Battery of EmergencyUnits Lighting
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 KWLocal ❑ Municipal0 Other
Connection
No.of Dryers HeatingAppliances KW FF Security Systems:No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters 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 pro-
vides 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 X BOND 0 OTHER 0 (SpecifYJ f1PNFRAI.ACCIDENT INS 7/11/18 •
"Per M.G.L.c. 147,s 57-61,security work requires Department of Public Safety"5"License (Expiration Date)
I certify,under the pains and penalties ofperfury,that the Information on this application is true and complete.
FIRM NAME: REILLY ELECTRICAL CONTRACTORS,INC /RELCO LIC.NO.:
Licensee: TAMER I RFT!I V Signature 414;1LIC.NO.:A 16666
(If applicable,enter "exempt"in the license number line) Bus.Tel.No.: 508-771-2040
Address: 110 OLD TOWNHOUSE ROAD,SOUTH YARMOUTH,MA 02664 Alt.Tel. 508-400-8936
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.FAX-508-760-1425
Owner/Agent I PERMIT FEE:
Signature Telephone No.