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Home My WebLink AboutBLDE-22-006636 Commonwealth of Official Use Only Permit No. BLDE-22-006636 11 Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.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:5/17/2022 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) 3 JERUSHA LN Owner or Tenant Jeff Lareau 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 ❑ No.of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Septic'pump&alarm. 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 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 1 Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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 Equivalent No.Hydromassage Bathtubs No.of Motors 1 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: JEFFREY T FOSS Licensee: Jeffrey T Foss Signature LIC.NO.: 36938 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:33 SULLIVAN RD,W YARMOUTH MA 026733543 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: $50.00 barn/ RECEIVED r AY 17 2022eon wsatth o�///aeaac�uaslYa fficial Use Only Permit Noi• 22- K .1UING DEPARTMENTP� �o �awicse �► = e_- ' 'REVENTION REGULATIONS Occupancy. 1/07] and Fee Checked (leave blank) APPLICATION FOR PERMIT TO PERFORM ELE TRI AL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC,527 C 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 5 1' 0101 City or Town of: YARMOUTH To the Inspector of Tres: By this application the undersigned gives.vice of is or in ration to perfo the electrical work described below. Location(Street&Number LI1 Owner or Tenant ,a .e4 C^ a Telephone No. Owner's Address Is this permit in conjunction with a building permit?Purpose of Building yeS ❑ No X (Check Appropriate Box) Utility Authorization No. Existing Service /'j o Amps ge i g t/Jvoit5 Overhea'd(J Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity Locati and t e of Proposed$I Inn l rival Work: / Ime,wiiw „ Hier kri Tom/ Completion of the followinvable may be waived by the In vector of Wires. U No.of Recessed Luminaires No.of Cell:Sus . No.of ., p (Paddle)Fans Total No.of Luminaire Outlets Transformers KVA CA No.of Hot Tubs Generators KVA ,l No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grad. grnd. ❑ Battery Units a` No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and 1 No.of RangesInitiating Devices No.of Mr Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump�Number Tons j KW No.of Self-Contained 1 To : I Detection/Alerting_Devices No.of Dishwashers Space/Area Heating KW Local❑ 1 nicipal No.of Dryers Connection ❑ Other' ty Heating Appliances KW Security Systems:* No.of Water , No.of No.of Devices or Equivalent Heaters No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors l Total HP Telecommunications Wiring: OAR: /� No.of Devices or Equivalent Estimated Value of ctrie Work: Attach additional detail if desired,or as required by the Inspector of Wires, Work toStart: (When required by municipal policy.) spections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO : Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liabili insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coy ge is in force,and has exhibited proof of sam�e�o t e pe it issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) 61�"l 6) x/Ce ev /q' 0_. I certify,under the pains and penalties of perjury,that the information on this appCica_Lion is true an complete. ®`FIRM NAME: Licensee: �� LIC.NO.: —//aa Signature /A/ `�1 la ,r (If applicable,eat 'exe�t"i be a in 'fj t LIC.NO.: a � Address: 3 (� �f� � r��/�'I�f/� �fi� / �+� Bus.Tel.No. i f *Per M.G.L.c. 147,s.57-61,security work requires Department of P/b is afety"S"Lice Alt.Tel.No.: 1/jt'/L« ��lQt OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normallyv required by law. By my signature below,I hereby waive this requirement. I am the(check one owner owner's a nt. Owner/Agent Signature Telephone No. P PERMIT FEE:$