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Home My WebLink AboutBLDE-22-000192 ' '<>t1 : r ommonwealth of Official Use Only E Massachusetts Permit No. BLDE-22-000192 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:7/13/2021 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) 43 HOLLY LN Owner or Tenant Dave Fimiani Telephone No. Owner's Address 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: Bathroom&laundry addition. 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. 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. To No.of Alerting Devices 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 Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent 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: JASON VIOLETTE Licensee: Jason Violette Signature LIC.NO.: 51767 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 11 QUEENS BAY LN, BOURNE MA 025325571 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 c 0 7/r1(/u .. �1l/� 3/M2/eS (V3o4n at RECEIVED J U L 12 2it2:1, Convnonwsatth o`Maddacliwsttd Official Use Only P -1 c� n crmtt No. �22�3(q Z BU I L D I N G D 34en T 2 spartmanf o/.}ins&rvrced._ y Occupancy and Fee Checked �`=, :OARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] peeve 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: City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice o hi or her intention to perform the electrical work described below. Location(Street&Number) 14 3b li ,1'- Owner or Tenant ! ,q,V 1ri,'c,r\ Telephone No.7'[-3s2—7—a-10 to 1 Owner's Address Is this permit in conjunctionwi a building�1frp�°°it? Yes LTJ No 0 (Check Appropriate Box) Purpose of Building i) 1Zm q,C d)11 t)n Utility Authorization No. Existing Service 10 0 Amps I )0/a y(j Volts Overhead L� Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: \\),;),..1,) ., ) `dl -cc..,- ( 0,-L Je,„ ;-- La c,21'-k + 6. 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 �1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No.of Emergency Ligating _grnd. ❑ 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 K Initiating Devices II! No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposer Treat Pump Number Tons KW_ No.of Self-Contained Totals: ��- Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Cnection 0 other No.of Dryers Heating Appliances KW Security on No Devices or Equivalent No.of Water rKW No.of No.of Data Wiring: HeatersSigns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: 0,-, Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value o Elec 'cal Work: /5 DU (When required by municipal policy.) Work to Start: ' Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VL GE: 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE (BOND 0 OTHER 0 (Specify:) I certify,under thepins and penahi f pe ,that the information on this application is true and complete FIRM NAME: \c Sv."1 �►tj kikalt, LIC.NO.: S7f(07 Licensee: 'j Signature 4- . LIC.NO.: (If applicable,ens "exempt"in t license number lin . Bus.TeL No.:5O`t'7 )(1, 9 2 9 n Address: /I IA �.Y)S (:r k---e • tbW-((7 • 53 L2c)-3-3 Alt.TeL No.: *Per M.G.L.c. 147,s.57-61,se ar, work requires epartment of blic 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 below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$