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Home My WebLink AboutBLDE-19-003288 \1`1 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-003288 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:11/29/2018 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) 34 WOOD RD Owner or Tenant DUMONT CHRISTOPHER R Telephone No. Owner's Address 34 WOOD RD, SOUTH YARMOUTH,MA 02664-4141 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 ❑ 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: Miscellaneous repairs or additional devices.(See attached) Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans INo.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above CIIn- ❑ No.of Emergency Lighting gird. gird. 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/Alertine Devices No.of Dishwashers 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 Silas 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 ❑ (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 ant the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 W21 Vq1 (el li fir¢ ) — ,A n � i iv � CPIISOSOMIVIIS of/r/aalachaits .= .. c•pUse On Perm Permit Zly 9,--:aapartmento`J�nepervlServices Occupancy and Fee Checked mob' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] . (leave blank) APPLICATION FORPERMIT TO PERFORM ELECTRICAL WORK Z All work to be performed in accordance with the Massachusetts Electrical Code(ME 5271200 J1 W (PLEASE PRINT ININKORTYPE LLLVFORMATI0h9 Date: // ,).$'/� N City or Town of: YARMOUTH To the Inspector of Wires: :v By this application the pndersigned gives notice of his or her intention to pe tm the electrical work described below. • W t\-)c..! Location(Street&Number) 9 WO oei n r LU �p (.9 Owner'or Tenant C!,( r t S /l0�).04." n,4Y� Telephone No. U$73 7�7/b Owner's Address 5i. m io Is this permit in conjunction with a building permit? Yes 0 No Purpose of Building (CheckAppropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead Q Und gid❑ No.of Meters _ New Service _ Amps I Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampadty -- govation and Nature of Proposed Ele cal Work: ph tte 7t- !'�j hq ll 7 ttf9// V S Li V 7` -IM 4009 47 1--efcr of deDe••• i---.tti9-e- —/9etPt U IAN 0 K► .L.e,- LEFT- evr s n }n'1 /5v 17--11 I—I r/ 7 Completion of the followintlable m be waived by the ftpeclor of Wirer. No.of f Q C� No.oPRecessed Luminaires No.of CeIL-Susp.(Paddle)Fans - Transformers- Total yt l No.of Luminaire Outlets No.of Hot Tubs Generators KVA t lJiur No.of Luminaires Above In.. No.of!;m ea _T Swimming Pool �rud. 0 grna. 0 Battery Units cY l.tgnmg - Q� 1 t No.of Receptacle Outlets No:of Ort Burners FLpoOFIRE ALARMS INo.ofZones til L . No.of Switches No.of Gas Burners No.of Detection and hr1 Initiating Devices Total - No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number ITons I KW No.of Self-Contained - jNo. Totals: Detection&Alerting Devices of DishwashersSpace/Area Heating KW' KW Local❑Municipal Connection ❑ Odra No.of Dryers Heating AppliancesSecurity S Systems:* No.of WaterNa of Devices or Equivalent \ Heaters KW No.of No.of Data Wiring Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total Hp Telecommunications Wiring: 1 U OTHER: No.of Devices or Equivalent N Attach additional detail if dewed or as required by the Inspector of Wires. J\ stimated Value of Electrical Work (When required by municipal policy.) work to Start Inspections to be requested in accordance with MEC Rule 10,and upon completion. p` INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless 7' 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 certify,under the pains and penalties of a 'ury,th information on this ap licatiion is true and complete. FIRM NA E J_ avec hi I��l 0 eti�/Cfi'+ .Jit' C LIC.NO.: �/ �/€ Licensee: l tp /1v Signature/ R0 jestQ��_ LIC.NO.: 3 (Ifapplicable,enter"(Tempt"in the license numb line) Address ` 7 ffil(yti p7 vs LA/ (t/. j��yvl' Bus.Tel.No.n0 J •Per M.G.L.c. I47,s.57-61,security work requires Department of Public SafetyAlt Tel.No.: OWNER'S INSURANCE WAIVER I am aware that the Licensee does nor have the liabilityLin.No. � required bylaw. Bymysignature insurance0owner coverage no's age Owner/Agent below,I hereby waive this requirement. I am the(check one) owner ❑owners agent 1 Signature Telephone No. I PERMIT FEE: $ °v 121Q