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Home My WebLink AboutBLDE-21-000912 yt�� Commonwealth of Official Use Only Y . t Massachusetts Permit No. BLDE-21-000912 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:8/23/2020 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) 64 BETTYS PATH Owner or Tenant BUSSIERE JOHN M Telephone No. Owner's Address BUSSIERE LINDA A,64 BETTYS PATH,WEST YARMOUTH, MA 02673 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: Remodel kitchen&dining rooms. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 23 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 16 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 12 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/Alerting Devices No.of Dishwashers 1 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 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 rR 9I ( o P (1(n1/24 1\.iietlets[ . .. A q fi i—oesmoniveaak 4 Maedackstosit4 , ir-cial Use On Permit No. C.--'—:22'( 2sparemni45,,ms.,„icsa Occupancy and Fee Checked '-. ,- BOARD OF FIRE PREVENTION REGULATIONS [Rev.1107] (leave blank) .;., 1/4...L (pLARAPSEPpLRIINTCAINTINIOKNORFTY0PERALLPEZialTn.T00A,PERFORM ELECTRICAL WORK City or Town woodcwistoobef:Perf°m*deS diVkin accmiguwe with the Magsachusetig Ehetricd Code (MEC), To the Inspector os f27WeMireSR 11: By this application the undersigned gives notice of his or intention to perform the electrical work described below. Location(Street&Number) 6 if 3 e?`;--y's. pimi 72 cf—Z1Z- 5--e45- u 1.-- Owner or Tenant ZO/i/t/f thubig 8'ciss/me- Date: 6-is'- 20?d :12.00 Telepho itijfin.% r SO IS' S'r •C`' Owner's Address Cf eArrf's P47-11 wt-57 V44Ale t WI/ 4.- 4' i --, I ;fr _.., 0 ftil q i Is this permit in conjunction with a handing permit? Yes ri] No 0 (Check A ropcIax) Purpose of Building ReMabe- Utility Authorizadon No. & vu 42020 i , /„._ Existing Service Amps / Volts Overhead El Undgrd 0 / INew Service Amps / Volts Overhead 0 Undgrd 0 No.of M Number of Feeders and Ampacity 9 e 20 a„stioi, ez4Aee e IS cunpt, Location and Nature of Proposed Electrical Work: REJLiebet ar kfrc iltriv i D ay Al 4 grA.5 .,. NA Completion of the followinktobk nr be waived by the Intimmor of Wires. ii Total til No.of Recessed Luminaires zs No.of Cell-Snap.(Paddle)Fans f6 7%i:formers ICVA CI No.of Lando*,Outlets No.of Hot Tubs Generators KVA No.of Luadnaires Swimming Pool Ablwe,, _ 0 iy: 0 r,‘"EunimerreYughnag No.of Receptacle Outlets /6 No.OM Burners FIRE ALARMS No.of Zones -i- C3=:111111M1111 No.of Gas Durum 'a, I , rt No.of Ranges No r iliti4e- No.of Air Cent Tons No.of Alerting Devices No.of Waste Disposers Detecdon/ ___-,,,LiLt. Deviees i r t Art Na.of Dishwashers / Spam/Area Heating KW Local 0 0 Other Conan:don No.of Dryers Reefing Appliances KW Prri No ..---r-,..-,of I ' - or 0. 11 Ns. , N 0.0 Data Wiring: Heaters KW Ballasts No.of I -- or No.Rydromassage Bathtubs No.of Motors Total HP No.of Device's , ,OTHER: Attach additional detail ildeshert ores required by the Inspector of Wires Estimated Value of Electrical Work: Is *,.'3L _ (When required by municipal policy.) * Work to Start Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSIJRANCEVERA rthrss 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 Ej (Specify* I me*,under the pains and penalties ofpediry,that the inforstation on this appikadon Is hue and complete. FIRM NAME: 'a tti,c/4- LIC.NO.: Licensee: Signature LIC.NO.; Wapplicabk,enter" tin the license'timber line) Address: Alt.Tel.No.: *Per M.G.L.c. 147,8.57.61,sc------Z.Ci ---rity work requires Department of Public Safety"S"License: Lie.No. ----------- OWNER'S INSURANCE WAIVER: fain aware that the Licensee does-not have the liability insurance cov notmally required by law. By my signature below,I hereby waive this requirement. lam the(check one IR owner a owner's !'.. Owner/Agent Signature ..........________ _ ________Telephone No. PERMIT FEE:$ ____.