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Home My WebLink AboutBLDE-19-002761 '4 Al'. ,. Commonwealth of OffcialUseOnly E WA Massachusetts Permit No. BLDE-19-002761 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:11/6/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 14 LILAC LN Owner or Tenant DAVID LAURIE C Telephone No. Owner's Address 14 LILAC LN,YARMOUTH PORT, MA 02675 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 ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install receptacle. 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. lir;d. BatteryUnits No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatine 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/Alertine 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 Watery No.of . No.of Data Wiring: Heaters Siens 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: John R Hassay Licensee: John R Hassay Signature LIC.NO.: 38186 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:28 THAYER ST,SOUTH DENNIS MA 026603717 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 signature below,I hereby waive this requirement.I am the(check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 ``\-d\4`s \iiii .- y Commonm<a el Massachusetts a,- Mal Use On 4 =let c'� cc'7 pp 1 - - gid atparla ent of Jlre--Cervices Permit No. • �• n -1r Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS . MI ' peke 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 INKNETION EALLINFORMATION) Date: AJov (' 20( r City or Town of: YARMOUTH To the Inspector of kires: By this application the undersigned gives notice of his or her intention tnerform the electrical work described low. • Location(Street&Number) Lir[ Aut.e 7 ROwt..1 LA< ' Fatil- .5br--- Owner or Tenant L.It ✓'t e 7Da V t c Telephone No _/ ,S Owner's Address Is this permit in conjunction with a building permit? Yes Purpose of Building �� N0.120 (Check Appropriate Box) t ✓tC Utility Authorization No. Existing Service Amps // Volts Overhead Q Und grd❑ No.of Meters New Service Amps I Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity • Location and Nature of Proposed Electrical Work: C Fr Z ,+.. 0,1 r tic 14 4-P [ Nil✓vt !/1 0,1 Cot 1 144 N C` watt e 6l Fa<emag4- P.:iANG cQ 2(9_0vLt / Completion of thefollowinpitable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cet7 Susp.(Paddle)Fans No.of Total Transformers }CVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ln- No.of imergency Ltgntrn - ttrud stud. 0 Battery Units g 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. Ton No.of Alerting Devices • No.of Waste Disposers Heat Pump Number Tons W No.of Self-Contained - Totals:I I IKDetection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' Municipal Low Q Connection 0 Other No.of Dryers Heating Appliances KAY Security Systems:" - .ofNo.of Devices or Equivalent No.of Water No Heaters 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 derired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Stare//- S- I g" 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 Fp 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: ��ff LIC.NO.: Licensee:Llo (tut iyR55"4 Signature LIC.NO.:3_ ( _ (If applicable,enter"etas 'in the Bomb member line.) Address. 2Fr /GIa ma, Bus.Tel.No. yyoS :Die" KCS AIL TeL zt- j o 49 `Pet M.G.L. c. 147,s.57-61,4ecur ty work requires Departmentc.No.t of Public Safety"S"License: LiTe ,-7-c OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally t required by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner 0 owner's agent m Owner/Agent Signature Telephone No. ( PERMIT FEE: $