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Home My WebLink AboutBLDE-19-001587 A ,., Commonwealth of Official Use Only ® Massachusetts Permit No. BLDE-19-001587 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.l/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:9/17/2018 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) 1 MONROE LN Owner or Tenant SWANSON ERIC Telephone N, Owner's Address SWANSON ELIZABETH V, 1 MONROE LN,WEST YARMOUTH,MA 02673 ---.` Is this permit in conjunction with a building permit? Yes 0 No 0 , heck Appropriate Box Purpose of Building Utility Authorization N r. - " x Existing Service Amps Volts Overhead 0 Undgrd 0 No.of eters _ t L. ;i AL. c New Service Amps Volts Overhead ❑ Undgrd 0 ' No. . eters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Repair exterior service,upgrade grounding,&replace eye bolt. 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. gnd. 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. 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 0 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 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 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 9 00/rg L- Commorwealth of///aaSachlt.4ias Ofn U Only^ I �az Q 1 _ c'� �7 [� Permit No, ll L . `-J-�1 1JaParmanf o{lira JerviCeS Occupancy and Fee Checked • BOARD OF FFIRE PREVENTION REGULATIONS [Rev. 1/07] any',blank) �' APPLICATION FOR,PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetu Electrical Code ,527 12.00 p I- (PLEASE PRINT IN INK OR TYPE ALLINFORM4TI0N) Date: 5 3!A' { z w m L City or Town of: YARMOUTH To the Inspector o Wires: !IE • By this application the lmdersigred gives notice of his or her intention to � perform the elect-ical work described below. g. I Location(Street&Number) / frj(j/0k109 Lit/ VOwner•orTenant 6 n )C 50 VIA Me. J Telepho . 7 -c /� z „�L Owner's Address Q 4 Q 7 ILI o Is this permit in conjunction with a building permit? Yes ❑ No IX (Check Appropriate or m m Purpose of Building Utility Authorization No. _ r • Existing Service_ Amps / Volts Overhead Q Undgrd❑ No.of Meters _ New Service _ Amps / Volts Overhead❑ Undgrd ❑ Na.of Meters Number of Feeders and Ampacity O C Location anted Natu ._• ..osed Electrical Work: 6 r 6 F /00/9.. JUS rJ�R�{C �s.f✓i K—� Q - /9 ret Completion of the following table may be wailed by the Inspector of fret, No.of Recessed Luminaires INo.of cen.-Snsp.(Paddle)Fans JNo•of Total (Transformers ICVA No.of Luminaire Outlets INC.of Hot Tubs Generators KVA ' No.of Luminaires ISwimmiag Pool Above In_ No.of- Unme,envy t ignumg crud. 0 crud. 0IBa _ No.of Receptacle Outlets• _U No.of Oil Burners !FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners • No.of Detection and No.of Ranges INo.of Air Cond, Total Lnitiatine Devices c\ Tons No.of Alerting Devices No.of Waste Disposers IHeat Pump I Number I Tons I KW No.of Self-Contained ��\ggq►►V„iiil��111 Totals: Detection/Alertin?Devices No.of Dishwashers Space/Area Heating ICY peat, Municipal Q Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Rriring Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunication Wiring: No.of Devices or Equivalent - OTHER • Attach additional detail f desired or as required by the Inspector of Wirer. d ra Estirted Value of Electrical Work (When required by municipal policy.) etWork 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 inclMAing"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: INSURANCES BOND 0 OTHER 0 (Specify:) I tenth', under the pains pd penalties1ofpajury, at the information on this application is true and complete. g FIRM NAME: (i( )01 )Cf' U I , I� ,p to ciao,. ;it LIG NO.: / < Licensee: WO I ei, Ian rgnature let,L-� LIC.NO.: (If applicable, enter"exempt"in the linens mber line.) ((V//"`�� Address. ,cif D,)„.w Ln/ (N }(titAti3OL - %47 Bus.TeL No.: fir_ �' D j `Per M.G.L.c. 47,s.57-61,securitywork requirese( ty Alt.TeL No.: ^� h aremrne Public not hoe liabse: Lic.No. — OWNER'S INSURANCE WAIVER I am aware that the Licensee doer not have the liability insurance coverage normallyf-/ It required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner�rnt r Ower/Agent • Signature01 nTelephone No. I PERMIT FEE:$ !J- 0101. r