The URL can be used to link to this page

Home My WebLink AboutBLDE-19-003107 a� Commonwealth of Official Use Only '�E .4,► Massachusetts Permit No. BLDE-19-003107 7BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.l/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 INFOR.MA lIOM Date:11/20/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of ms or her intention to pertomr the electrical work described below. Location(Street&Number) 29 SUNSET DR Owner or Tenant GOLD MICHELE Telephone No. • Owner's Address 65 CHARLEMONT ST,NEWTON, MA 02461 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install two receptacles in basement. 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- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 2 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 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 destred,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 (Ifapplicable,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 .e ® a tt ZA 1I 6 tee \\A C.a i sWC � , � Af /� t-a U./ .1 .non malg of///analmatti . Use nfirri 11 2.parfinent of Tire�ervicee Permit No. �' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS -Rev. (lean blank) APPLICATION FOR:PERMiT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 7 1 00 -( If:1 , t`, .EASEPRINT ININKORTYPE ALL INFORMATIO?9 Date: 1/ )7 j6 f:1W City or Town of: YARMOUTH To the Inspec or of ires: - • — o i this application the undersigned gives notice�hisintention to"form the electrical work described below. > c.t o tion (Street&Number) at r .j in o er or Tenant 717eK CO Telephone No l7-77?-cY°S U $ o ) I er's Address 34 T—.445.1951- civ + S T B te-e— w Z ' 4s : ' permit in conjunction with a building permit? Yes ❑ No- (Check Appropriate Box) uBuilding tpose of Utility Authorization No. 1 Existing Service_ Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service _ Amps / Volts Overhead❑ Undgrd gr 0 No,of Meters Number of Feeders and Ampacity Location and Nature �of Proposed Electrical Work:sper, _ C./CCi it I-1 M Ce-j.1 e-P Completion of the fol/owinttate a maybe war J' eed by the Inspector of Wires. No.of Recessed LuminairesCa.-Symp.(Paddle) No,of Total �/ No.of Cert S Fans Transformers ICVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA - • No.of Luminaires Swimming Pool Above 0 In- No.ofttery EUnitsmergency Lign Ing grad.. crud. 0 Ba L No.of Receptacle Outlets No.of Oil Burners I FIRE ALARMS INo.of Zones (\ No.of Switches No.of Ranges No.of Gas Burners No.of Detection and `� • Total Initiating Devices No.of Air Cond. v Tons No.of Alerting Devices c �r No.of Waste Disposers HeatPump I Number I Tons I KW No.of Self-Contained v Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Loral 0 Municipal Connection 0 °ti!er No.of Dryers Heating Appliances Kw Security Systems:* No.of Water No.of Devices or Equivalent Heaters KWNo.of No.of Data Wiring• ;44. Signs Ballasts No.of Devices or EquivalentNo.Hydromassage Bathtubs No,otMotors Total HP 'telecommunications Wiring: No.of Devices or Equivalent OTHER _ Attach addition/detail if desiree(or as required by the Inspector of Wires. Estimated Value of Electrical World (When required by municipal policy.) 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.ONE: INSURANCE�_B ND 0 OTHER 0 (Specify) !cerkfy, under th pa'tu a peva! s ojp��ary, a1 the i a arfox on this a kc u ue and complete. FIRM NAME: (4 T/ (' / !( t7 (/J 7 d pi , C LW.NO.: �� Licensee: Signature e'yaQ,f ` LIC.NO.: arapplicable.,enter"(Tempt"in the license number lige.) WWW��---(J•� �./�7 Bus.Tel.No: 1. Address. 7 /.s. 7-6],security / N (,l f, ant o/f n-- "License: _ Alt Tel.No.. M l{y, ,-64/71 J *Per M.G.L.c. id7,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. — 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 i am the(check one)0 owner 0 owner's agent Owner/Agent Signature Telephone No. I PERMIT FEE: S j