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Home My WebLink AboutBlde-20-001754 Commonwealth of Official Use Only tit; Massachusetts Permit No. BLDE-20-001754 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:10/1/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention ar electrical work described below. Location(Street&Number) 481 BUCK ISLAND R I Owner or Tenant DETORA DEBORAH S Telephone No. Owner's Address 61 THOMAS DR, CHELMSFORD, MA 01824-2061 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: Replacement distribution panel. 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. 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 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 ❑ 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.: 21302 (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 Signatures Telephone No. PERMIT FEE: $50.00 "GAL (O( j ( (c eCt 1I s4 1 111/4;)Vij Cammor vea(t oil efrlas&aehu 3 _ ��Official Use Only�t ,/ Apartment Jervite3 Permit No. �= ° Occupancy and Fee Checked - BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK . All work to be performed in accordance with the Massachusetts Electrical Code ,527 12.00 (�,� (PLEASE PRINT IN INK OR TYPE ALL 1VFORMATI019 Date: / 3e) // J r�� City or Town of: YAIdMOUTH To the Inspector of Wires: By this application the lmdersigned gives notice of his or her intention to perform the electrical work described below. M Location(Street&Number) d ? U—1 7 %. Owner-or Tenant , �j y(,�— Telephone No.JZj—vsy--575-g `-' cr.) Owner's Address ‘f 711-0,s4i S 2r, rl_e_ ." -4.4o/ ✓M-- O/c3?1 Is this permit in conjunction with a building permit? Yes 0 No Et (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead Q Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Anrpacity e Location and Nature of Proposed Electrical Work: 7,1ze_e_e ,7-- v 6' j ' "„e c' /, 1L✓ • Completion of the following table may be waived by the Inspector of Wires. `No.of Total No.of Recessed Luminaires No.of Cam.-Snsp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swilmmiag Pool Above ❑ In- ❑ No.ofii.mergenty Lagitung grad.. and. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones V No.of Switches No.of Gas Burners 'No.of Detection��Devices ,—.1 No.of ges Total Initiating Rana No.of Air Cond. Tons No.of Alerting Devices Lil No.of Waste Disposers Fleet Pump Number-Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW L�0 Municipal 0 Other Connection 2No.of Dryers Heating Appliances KW 'Security f evices or Equ* ivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices _ or Equivalent ` No.Hydromassage Bathtubs Na.of Motors Total HPTelecommunications Wiring: Na.of Devices or Equivalent O 1 i3h.R ,d 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 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 certifr,under the�pains and penaltiesperjury,ofperl ,that the r►nat�"ioon otrthis application is true and complete. /-� FIRM NAME: lJ U 1`�--e r' t)3 ; W�t l ' (� t Jt t"\ t((tii TAX LIC.NO.: a/ oD ' Licensee: (Apet 14...zr )4Q.l( Signature I)0,.Q 1 /, JJ2/L LIC.NO.:LJ' ire 3. (If applicable.enter"exempt"in the lie number 1 ire.) /n� Bus.Tel.No.: Address:7 isitoio'(�C-Q h.1 - ST )1.et rkJ 0 IF/PT Alt.TeL No.:,(Ov;pry- 7, J *Per M:G. C. 14 ,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)❑owner 0 owner's agent. t Owner/Agent 1 Signature Telephone No. I PERMIT FEE: S -b 1