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Home My WebLink AboutBLDE-23-003639 Commonwealth of Official Use Only f—• ; Massachusetts Permit No. BLDE-23-003639 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:1/5/2023 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) 25 CONSTANCE AVE Owner or Tenant LACEY JEFFREY Telephone No. Owner's Address 133 I ST APT 2, BOSTON, MA 02127 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: Basement sitting room. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 13 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 2 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 11 No.of Oil Burners FIRE ALARMS No.of Zones 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 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 0 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 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: JOSEPH P ROSE Licensee: Joseph P Rose Signature LIC.NO.: 21335 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 Beverly Rd,West Yarmouth MA 026733559 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 75' .0 -- RECEIVED ."' 1 A N O 4 202r° nwaanh of Maddachadsted Official Use Only �■ ,. C',.JNI`I elf �r. partm.at o�5 J Permit No. �i23— 3(aJ9 I r"LDING DEPARTMEN ir. trvaed ! `— ►ROGR p REVNTION REGULATIONSOccupancy and Fee Checked [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) (MEC),527 CMR 1 z.00 City or Town of: Date: j r.�.��'3 By this application the undersigned givYARMbis or O U6 H intention to To the 1 pec or of Wires: Location(Street&Number) S CO �°�the elelctri1ca+l work descri below. Owner or Tenant •' r-al C-4.‘ Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes Purpose of Building NO 0 (Check Appropriate Box) Linty Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters _ New Service Amps / Volts Overhead Number of Feeders and Ampadty 0 Undgrd El No.of Meters Locati n and Nature of Proposed Electrical Work: 1 r i ,S ( ` hfl cv1 �k+CYt� �^tf,� .,A 4Y,,3Cn-,Ln�' Completion of the followingtable may be waived by the In vector of Wires. To No.of Recessed Luminaires 3 No.of Cell.-Snap.(Paddle)Fans )No.of No.of Luminaire Outlets No.of Hot Tubs Generators eennneraraoomers KVA tors KVA mot, No.of Luminaires Swimming Pool Above 0 In- No.of Emergency Lighting �! No.of Receptacle Outlets d' d• ❑ Batte Units` No.of Oil Burners FIRE ALARMS No,of Zones No.of Switches (.e) No.of Gas Burnerso.o ec on an III No,of Ranges Initiatln Devices No.of Air Cond. °m No.of Alerting Dev ices Tons No.of Waste Disposers `eat amp `um er . ors " °o.o e oat: n Totals: ..__. _ _.:_........._._..... No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW Local❑ C un c pinn 0 Other No.of Dryers Heating Appliances KW ecu ty yst ms:* o.o a Water o.° No.of Devices or uivalent Heaters KW o.o Data Wiring: Si s Ballasts No.of Devices or uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommun a ors gg OTHER; No.of Devices or ulvalent Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: (When required by municipal policy.) INSURANCE COVERAGE: Unless waived by thtions to be e ownetr n ed in accordance r th peg MEC R performance electrical worke 10,and upon k may aytiss the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such 'vane is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE !e BOND 0 OTHER 0 (Specify:) I certify,under the pains and pena, , of perjury,that the information on this application is true and complet FIRM NAME: Licensee: . LIC.NO.: <)`33 A (If applicable ter 'exempt" the i Signature LIC.NO.: Address: e n um lu►e *Per M.G.L.c. 147,s.57-61 ecun'G ty work Bus.Tel.No.. i< ) OWNER'S INSURANCE WAIVER: i a aware thatth�eLiccnsfee does no t have thLicense: 1 Anse: Alt.TeL No.: --------- OWNER'S by law. BymysignatureLin.No. below,I hereby waive this requirement, I am the(check one insurance coverage normally Owner/Agent � owner ■ owner's a:ent. Signature Telephone No. PERMIT FEE:$