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Home My WebLink AboutE-18-5565 07 i s Commonwealth of Official use only tfloala `� Massachusetts Permit No. BLDE-18-005565 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked rRev.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 ALLINFORMATION) Date:4/5/2018 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) 8 JACKSON AVE Owner or Tenant BISSONETTE JOHN F Telephone No. Owner's Address BISSONETTE JUNE E,8 JACKSON AVENUE,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters r New Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters t Number of Feeders and Ampacity n Location and Nature of Proposed Electrical Work: Remodel basement area. 0 Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires I No.of Ceil:Susp.(Paddle)Fans No,of , Total 1 TransformersKVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA lS No.of Luminaires Swimming Pool Above 0 In- ❑ No,of Emergency Lighting be grnd. grnd. Battery Moils , No.of Receptacle Outlets 20 No.of Oil Burners FIRE ALARMS No.of Zones lb IA No.of Switches 6 No.of Gas Burners No.of Detection and Initiating Devices ( No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons 1 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 0 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 lIP 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: Thomas J Lally Licensee: Thomas J Lally Signature LIC.NO.: 9234 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 110, MANOMET MA 023450110 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 lehge q 468 Kt R ( jEtr) Veil q - in lies ITS IAJ a L' WWtaes t41 naciatt k _muco QeQ i(fnl690% 91-Cit.sa �� 1.--r l'i\ latnmonroeaig of///aeetekeSeEd Official ID " Use�Only 2l'7� �c7/ r(� PermitNo._ 8�� 6d1�' " cparfinenl`of ire Scrctcre p Occnyaacy and Fee Checked _ = BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07j (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to bepel-formed in aeeottnce wit]the Massachusetts Elecaical Code (PLEASE PRINT INJNKOR TYPE ALL INFORMATION) Date: (MEc�,527 CMR(zoo City or Town of: yM0U7$ 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) • v �. O A' Owner'orTenant /ask y I . cosi/, i Telephone No. �� Owner's Address tun.c F 2;` sZ --7 Is this permit ii conjunction with a buildingpermit? Yes `wT No V �' . Purpose of Etulamg :.: (/< — ... ❑ (Check Appropr siz Boz) !.� // Utility Authorization No. s i Emoting Service' L!. ` I y /� Amps �/Q Volts Overhead �'� Uadgrd❑ No.of Mears V 1 r New Service (� 1 Amps / Volts Overhead❑ Undgrd❑ No.of Meters U a tilVic Number of Feeders and Ampaeity /00 • Location and Nature of Proposed Elec7iEat Wort / �� /--�ir�s./ ��351 Li -6 JI �7 ...000JJJ oe Completion of the following,table may be wcved by the Inspector of FYiret No.of Recessed Luminaires INo.of Cer7.Sttsp.(Paddle)Fans INo.of Total Transformers KVA No. of Luminaire Outlets INo.of Hot Tabs Generators • KVA ' No.of Luminaires a (Swim ming Pool Abovela- r-, No.of tsmergeacy Lighting _ Erna. ,rind- (Batter,Uai4 Na.of Receptacle Outlets Z 0 INo.of Ort Burners !FUZE ALARMS No.of Zones No.of Switches INo.of Gzs Burners • No.of Detection jW — Initiadne Devices No.of Ranges - INo. of Air Cond. Total Tons No.of Alerting Devices • No.of Waste Disposers (Heat Pump Number Tons" KW No of Self C ontained Totals: Deteetion/4ferting Devices No.of Dishwashers ISpace/Area Heating KWMunicipal Lin'O Connection 0 Other No. of Dryers (Heating Appliances Security Systems:' No. of Water No.of Devices or Equivalent Heaters KW No. of No.of Data Wiring: — Sins Bain No.of Devices or Equivalent Svalent ' No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Whin" No.of Devices or Equivalent — NiiEstimated Value of E e .'c Attach additional derail yrdesiredor as required by the Inspector of Firer. ` ord <raj (When required by municipal policy.) \ Work to Start - Inspections to be requested in accordance with MEC Rule 10,and upon completion. _` RAN INSU : a °• 'GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless �l the licensee provid proof of liability in ante including"completed operation"coverage or its substantial equivalent undersigned certifies that such coy a is in fame,and has exhibited proof of same to the permit issuing of ere. The CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) \• FIRM NAME- ter*, ander LIC. p and e of pa] ,that the information on this;,pke,.:.J_. . and complete. __��a�� LIC.NO.: �f'w2a� \ Licenser. Sign. re LIC.NO.: �,�'/ alfapplicable• ens ' the license er ine ,/ /D� '/� Bus.TeL No:7`' C . "-%Address. pX /41A7/4,74904e/ // 7 j 'Per M.G.L.e. 147,s.57-61,secwi work re Aft TeL No.. b quiet Department of Public Safety"S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nor 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 Owner/Agent Signature Telephone No. I PERMIT FEE: $