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Home My WebLink AboutBLDE-18-003157 or 0 Commonwealth of Official Use Only 1�� Massachusetts Permit No. BLDE-18-003157 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.1/071 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:11/28/2017 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice othis or her intention to perform the electric rk described below. A 1 Location(Street&Number) 80 GRANDVIEW DR c S9)44 . 5tyvl ,i Owner or Tenant (1315 1ER8 AC�f3�DEF TR Telephone No. Owner's Address BERNADaTRUST,80 GRANDVIEW DR,SOUTH YARMOUTH,MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check App ri p. Purpose of Building Utility Authorization No. NN�t ex.!, Existing Service Amps Volts Overhead ❑ Undgrd ❑ to sNew Service Amps Volts Overhead ❑ Undgrd ❑ No. 1ktNumber of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace panel,install 20 recessed lights,remodel kitchen,&3 bathr <3 C.) Completion of the following table may be waivedJJ<6byhj!'e A1/4:4; Wires. No.of Recessed Luminaires 20 No.of Ceil:Susp.(Paddle)Fans No.of I /,r/ 9 • Transformers (`tl/ Isis No.of Luminaire Outlets 10 No.of Hot Tubs Generators / K No.of Luminaires Swimming Pool Above 0 In- 0 No.of Emergency Lighting I grnd. grnd. Battery On its No.of Receptacle Outlets 4 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 8 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges 1 No.of Air Cond. TotaloNo.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers 1 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 Enuivalent OTHER: Attach additional detail jfdesired,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) 1 certify,under the pains and penalties of perjury,that the information on this application Is true and complete. FIRM NAME: John M Sousa Licensee: John M Sousa Signature LIC.NO.: 12911 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:6 RUSSELL RD,LEXINGTON MA 024202709 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OVVNER'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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 Ia utu( (41--/c 7 ., KiJ2 6/24oe . �y ' !. w fit e ww:iiJ frits 0-4cU Le e. fiU t �mmor. nig o f Mad,,.. .4etto O I Use Only sc7c� (� Permit No •�\`' =�a1_ 2epartinent el Jiro&mitts Oc` �_�� W BOARD OF FIRE PREVENTION REGULATIONS ev. l/O cyandFeeChecked Rev. l/07J • (]rave blunt:) -- APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK Al!work to be performed in accordance with the Massachusecrs Electrical Code(MEC),527 CV-AIM/0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: //ag-as City or Town of: YARMOUTH To the Inspector of Wires: . By this application the pndersig ied gives notice of his or her intention to perform the electrical work described below. • . Location (Street&Number) Slb GtronAle id i ti te_ Owner'or Tenant rjoy4 1 tKe/Jr" Telephone No. 51 Owner's Address $d Perk net_ C.». r"6 r/J_ In e Oat,r c Is this permit in conjunction with a building permit? Yes 3 No Purpose of Building 4e.4.6.41-444%. n �� // ❑ tCheck Appropriate Boz) L. /�ir94iHs Utility Authorization No. xiExisting Service Amps / Volts Overhead Q Undgrd❑ No.of Meters --- New Service Amps / Volts Overhead❑ Undgrd ❑ No,of Meters _ � • CI F Number of Feeders and Ampacity w Location and Nature of Proposed Electrical Work: Ask,/Jo teeerepss O(t m_ q n� n /' L / /� �• / I /� /�.e oXo�.V.tYY��aa III�N IK I AHskil e kw JLiapc / 4NNIYP/IC 'EX/ /�M( 7�W/f .4! - ~ i. •. .. . ��/7N �• la Ctor�bletion ofthefollowine able may be waived by thel No. of Recessed Luminaires INo.of Inspector of Wires. 11.1 CSI �O !No.of Cet1-S¢sp.(Paddle)Fans Transformers FNA ? No. ofLami:mireOutlets 'Generators • ICVA ' V p A /a INo.of Hot Tubs (jJ Z Na.of L¢mfaaires Above In- No.of Emergency Lighting. — g cy i t,h sus Svrimm Pool ems ❑ artid. 0 IBattery Units m m No. of Receptacle Outlets 9 No.of Oil Burners 'FIRE ALARMS INo.of Zones No. of Switches 4• No.of Gas Burners No.of Detection and C� Initiatinz Devices No.of Ranges / INo.of Air Cond. Total Tons No.of Alerting Devices • No.of Waste Disposers Heat Fump'Number 'Tons IKW No,of Serf-Contained Totals; I Detec/ttfit oninaDevices No.of Dishwashers / Space/Area Heating KW LocalMttaic3pal ❑Connection ❑ er No.of Dryers Heating Appliances KW Security Systems:t No. of Water I No.of Devices or Equi trvalent Heaters KW No. of No.of Data Wiring Sizns Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: Na valent of Devices or Equi OTHER - V• Estimated Value of Electrical Wprl` Attach additional tail ifderired or as required by the Inspector of Wires. /9 . (When required by municipal policy.) Work to Start: //-,25-9a.'7 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 tthe 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: NSURANCE 0 BOND 0 OTHER 0 (Specify:) I cerrtfy, tinder the paints and penalties ofperfuiy at the information on this t�� f application is true and compfeie FIRM NAME: "Y�1n.e� �or� CIPC .t- LIC.NO.: " 2* 1 Licensee: Zi/t..) SA)S Signature ay-applicable.enter "tempt"in the li acre her fine 9— LIG NO.: J%2 9/ / Address: Wcere4 S4.-ca �0"or {moi oa/�J Bus.Tel.No: �Q6C'�13y j Per M.G.L.e. 147,s.57-61,securitywork requiresAlt Tel.No.;bi?�,?y�7� OWNER'S INSURANCE Dep-f.. ent of Public Safety"S"License: Lie.No, ez WAIVER I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agent r Owner/Agent Signature Telephone No. ' PERMIT FEE: S 1