The URL can be used to link to this page

Home My WebLink AboutBLDE-21-006931 Commonwealth of Official Use Only E„tee Massachusetts Permit No. BLDE-21-006361 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:5/4/2021 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 etecmcat work described below. Location(Street&Number) 61 FLICKER LN Owner or Tenant Crystal Omsen Telephone No. Owner's Address 61 FLICKER LN,WEST YARMOUTH,MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appro. late Box) Purpose of Building Utility Authorization No. a Existing Service Amps Volts Overhead 0 Undgrd 0 New Service Amps Volts Overhead 0 Undgrd 0 1 44::64 . Number of Feeders and Ampacity /� Location and Nature of Proposed Electrical Work: Repairs or replacements per attached. Go) Completion of the following table may be . 41Pj wires. No.of Recessed Luminaires No.of Ceil:Susp.(Padd le)Fans No,of 1 Transformers ` y1� No.of Luminaire Outlets Na.of Hot Tubs Generators / 23 41 No.of Luminaires Swimming Pool Above ❑ In- CINo.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 KM' Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances Kim 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 ❑ (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 p ,o t Ceff o coeilNei s 7,) L I k-f`rz--- C T S.S "Z.,2p-C6 Ol C -1J 7l— 775/7622 vsv0/ km c' 6-41 iN eci«ti / L- Official Use Only �nurortuea frz o` ai3ac�u�alii g n 7 S' Permit No. :- l{ —63( I q _ , sPanmcnL oT .7 r srvicc5 Occupancy and Fee Checked • 'i BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/0i) " (leave bank) P { T 5 jarPERFORMR6r� ' WORK �� !� FOR �� TO =F imp n ��:_. All work to be performed in accordance with the Massachusetts El coital Code(heti 527 12.00 �� PLEASE PRINT Th'INK OR TYPE _ t `�(_ I1vFORl✓tiTTO�) a�eo � City or Town of: Y `, P 4[O T To the Inspector of Wires: . By this application the pndetsigned hives notice of his or her intention to perform the electrical work descnbed below. QLocation (Street c Number) 6 / t—LIG/ie 0 Owner or Tenant C/tyS// 0► PN Telephone No. - 77S—/, Q ,� Owner's Address 7e7,/� CZ, r✓r4.)M t/�c, (.1-6 � 'lii/ Di ,Re j ) Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. �til, �ri stir:;Service Amps I Volts Overhead E. Undgrd No. of Meters ,i't New Service amps / Volts Overhead D t ndgrd 7 No.of Peters W --°' Number of Feeders and Ampacity fj `l N Location and Nature o" posed Electrical Work.: fr_}/(J g G} I1 —ei `-"� pit i2 Completion of the following table may be waived by the Ir„soe:!or of Wires. Nab .., No.of Recessed Luminaires No.ofCeIL-Susv.(Paddle)Fans � I o ors fT 3 KVA No. of Luminaire Outlet lNo.Swu orn na Pool of Hot Tubs iC-eoerators Imo'=� ' �l No_of Luminaires Above Q In- i Ivo.of .mergency Lighting n r .� a Qrrld.. arlt{7_ Battery Units `o c. Q 7 No.of Receptacle Outlets INo_of OilBurners ct ALARMS Ri S _No.of Zone; V_ 7.-...; kl � No.of Switches (No.of Gas Biters ,No.of Detection and N Qfis tuitiat ati Devices . No.of Ranges No of Air Cond. ;Ohs iNe.of.inning Devices '-ri,. c �Io.of Waste Disposers Fleat Pump I Number I T ons 1 KW 1No,of Self-Contained Totals: 1 EDetectioul alerting Devices ., No. of Dishwashers ISpace/4rea Heating KW ?Low 0 Nur_ici tiou C �e ( Coanec[ia� SecuritySystems:'' •' ' No.of Dryers Keating Appliances ;�,t, Y \,� No.of Devices or Equivalent r No.of Water KW No. of No. of Heaters Data 'irinQ: .� I Sigmas Ballast No_of Devices or Equivalent I Q �l No. Hydromassage Bathtubs INo.of Motors Total HP N..,., T eleco[rtnanicatians Wiring:: ' �,.%t I No.of Devices or Equivalent I OTHER /?QJ .211 S5t�' ° 1 �(*- ? er'�n=rl`: r;�;� �� `J� - iii truth additional detail ifdestred or as required by the Inspector of Wires. LL • Estimated Value of Electrical Worms (When required by municipal policy.) r ��i Work to Start: Inspections to be requested in accordance with MvIEC Rule 10,and upon completion. a INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless In the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent The . undersizned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office, CHECK ONE: INSURANCE BOND 0 OTHER D (Specify:) I certify, tender the pains and penalties of perfary,that the let ornfation en this application is true and complete. r\} FIRM 14IAE: �� : i i ; ; p 1� CIL ,--2 -' , fi'0 L L'- ',.s. r 1. rl( cry-,,.:I l,.IUtt... LIC_Na: i� J 5. \,� Licensee: , ? c+:� II l /• 7 —_ ` �•, ,UC..l..r< KO i I:-•. Siignature f ,i Q L ,1 i-_ /L�,� -LAC.NO.:cf, j.��/ - (If applicable, enter'•Etempt"in the licer-se number line_ _ � �_ `"�_ �.1 � - � •� - // �� Bus.Tel.No.: �''. Address a 1 i.l i i r_- 7 :1 i ILi.-2 S i / rt vi 0 L YL "/' Ait.Tel.No.:,'9 C/C%7`pc.-1 - --- 4 i -Per M:G.L. c. 147,s.57-61,security work requires Depar•bnent 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 ❑owner's agent 7 Owner/Agent 1 Sigmature Talanhnn.Niel I PERMIT FEE: 5 50 CO