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Home My WebLink AboutBlde-20-002219 op , \i<<� Commonwealth of Official Use Only f. 'i / Massachusetts Permit No. BLDE-20-002219 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:10/21/2019 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 electncal work described below. Location(Street&Number) 2 PARSONAGE POINT Owner or Tenant EDW' ._a._ 'TRI 1,, Telephone No. Owner's Address '' PARSONAGE POINT,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a bui i ing 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: Split A/C system. 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 0 In- ❑ No.of Emergency Lighting grnd. grnd. Batter,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. 1 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 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.: 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 Signature Telephone No. PERMIT FEE:$50.00 C� (tI SI (9 t -- sp- L c) l C ae 0cict. c ic-A(Ye-Pc--'k-cA.— ,GJ Com�mmorwsa of M7assaehu.ietti Ofucial Use Only s�+1 ,. .1� artmsnt oi1. ire&micas M Permit No.l�� 1 1 i-=f Occupancy and Fee Checked = -= BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07] ( Ye blink) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ,527 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMAT1019 Date: 10 ?/ l City or Town of: YARMOUTH To the Inspe for of ires: By this application the tmdersigned tice of his or her intention perform the electrical work described below. Location(Street&Number) fCc,x j j jL. Owner or Tenant G eo(` I TLirtA a Telephone No.5 a ,3?S d/,.5— Owner's Address Is this permit in conjunction with a building permit? Yes ❑ Nog—_(Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps I Volts Overhead Q Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity to Location and Nature of Proposed Electrical Work: `�/f'� ,� U f7(M/) ,OI)cT S S 9'ewl jj i'U 4/V -I—Nt . i�r h� (� Completion ofthe foil table may be waived by the Ittsoector of lures. 'No.of Total No.of Recessed Luminaires No.of Cell-Susp.(Paddle)Fans Transformers KVA e 0- No.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of lrmergeacy Lighting ;Cad. snd. 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 Clf taitiatine Devices --.11 No.of Ranges No.of Air Cond. Tons No.of Alerting Devices C I] No.of Waste Disposers Heat Pump Number Tons KW No.of Sett-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW I, Q Municipal 0 Other Connection No.of Dryers Heating Appliances KW Security Systems:* ,,,��111... No.of Devices or Equivalent No.of 3 Wate ers , INo.of No.of Data Wiring: HeSigns Ballasts No. —_ , No. Hydromassage Bathtubs (No.of Motors Total HP Tetecoa i tie it tt } "' Na�f ' OTHER / 75 1 v(/,�n / Attach additional detail if desired or as fah;tahlpk4lchtiof Wires. Estimated Value of Electrical Work (When required by municipal policy.) Work to Start Inspections to be requested in accordance with MEC Rule 10 di L D I N G leDEPARTn M i_ti , upon compteUotr 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. e'I) CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I cert')3',under�p and penalties ofperfury,that the rncation ork this app!tcation Is true and complete. FIRM NAME: We{ i r ti3 ; ��.t L „-e f l Cr 1 OK) ��C. LIC.NO.: a jQ Licensee: l A�(-t_ . K a IASbgnathre Lion.,Q, 0„P LIC NO.: ' C p �, (Ifapplicable,enter"exempt"in the lie-age number l(ne) n Bus.Tel No.. r,` Address 17 It. DAgt Cr _ VIP CT Yet r/l4 0 LA-I �J J Per M:O. c. 1447,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lie.No. •. '....0 _ 7 7 — OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally S Ow�arreddA by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner ❑owner's agent l Signature Telephone No. 1 PERMIT FEE: .S 58 M-3