HomeMy WebLinkAboutBLDE-19-001759 J 'a Commonwealth of Official Use Only
i Massachusetts Permit No. BLDE-19-001759
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
FRev.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:9/24/2018
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) 125 SPRINGER LN
Owner or Tenant MCMAHON FRANCES W Telephone No.
Owner's Address JW MCMAHON&JE&SM MONTMINY, 125 SPRINGER LN,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: Replace kitchen receptacles,washer rec'p,&install recessed lights.
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 Ab0 ln- o No.of Emergency Lighting
grnove d. 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
Totals; Detection/Alerting 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 Data Wiring:
Heaters Signs 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: WALTER W KELLY
Licensee: Walter W Kelly Signature LIC.NO.: 51391
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:7 MONROE LN,WEST YARMOUTH MA 026732731 Mt.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:$50.00
C
_fritsta r,tt5fQa.tBA T.)-e.S 24-.S// $
l.ommotuna&of tr/a„ac ff, O cial Use Only ^
Us ryry, Permit Nn. Q-1 ��1JrParfmsnf o �i~swicd
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS . 1/071 ' Nave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12.00
"wa•SEPRINT ININK ORTYPE ALL INFORMATION Date: 7 .2y//g?
l W City or Town of: YARMOUTH To the Imp ctor of Wires:
`�{ I co. 1 s application the tatdersigned gives notice of his or her intention to perform the electrical work described below.
(Y\'J — c" II�`c :on(Street&Number) la-S— (�It fit,/ lar- �fG!`Mb
lii .o rorTenant
s�� ' 4- I M i h Telephone No.
U W . r's Address trt ,
V L.1 en IEtha permit in conjunction with a building permit? Yesint
i 11,,:_._.-_ FQrA�se of Building ❑ No. • (Check Appropriate Box)
m Utility Authorization No.
--._Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead 0 Und rd
0 No.of Meters
(ZQVAC,t W FSS W O& 'YLO le -I-
Location and Nature of Proposed Electrical''wwork:/Zoptewe 4.f- relikai ,L, Al) 3-the'p C`
ki:-Erttio roO$Jtet• fLOco 1Le - ,-vd c W cog Bitch-2
DCompletion of the followingtable may be waived by the Inspector of Wires.
v No.of Recessed Luminaires No.of CeiLSnap.(Paddle)Fans • No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ClIn- No.of Emergency Lighting
xrttd. gird. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
No,of Switches No.of Gas Burners No.of Detection and
Initiating Devices
C-11
No.of Ranges No.of Air Cond.
Total No.of Alerting Devices
• �3 No.of Waste Disposers Heat PumpNumber Tons KW No.of Self-Contained
Totals:I I I Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW' LocalMunicipal
..---2, Connection �1e1
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water No,of
3 Heaters KW No.of Data Wiring;
Signs 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 ifdesired or as required by the Inspector of Wires.
Estimated Value of Electrical World (When required by municipal policy.)
3 Work to Start: Inspections 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 •�—BOND 0 OTHER 0 (Specify:)
I I cemfy, under the pans an gentrifies Salary,tha t e info on on this application'''�yyu�nd complete,_
�( FIRM NAME: IJ'er V�. \Co k S40,1�•� tow LIC.NO. ade
3 Licensee:
)�-,n t• Sign re LIC.NO.:
(if applicable, en er"exempt"in r�license number line) Bus.Tel.No:
Address. Jt' () � I w• �/ Mil ,A
j *Per M.G.L. c. 14 ,s.57-61,security work requires Deparunentlof PublicPSafety"S"License:1.717- Alt.Lic.No.
Q 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. the(c
I am heck one)0 owner ❑owner's agent.
1- Owner/Agentare,
j Signature Telephone No. 1 PERMIT FEE: $ jt�