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Home My WebLink AboutBlde-21-006238 All Commonwealth of Official Use Only fE Massachusetts Permit No. BLDE-21-006238 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:4/28/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 81 SPRINGER LN Owner or Tenant TODD GLENN R Telephone No. Owner's Address TODD KATHLEEN M, 81 SPRINGER LANE,WEST YARMOUTH, MA 02673 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: Service upgrade. 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 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: JARLATH A GALVIN Licensee: Jarlath A Galvin Signature LIC.NO.: 10861 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 100 ACORN DR, OSTERVILLE MA 026551370 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 tI((i `f(3o(2( c ( : ls ) tv) A.._ c(q i cf./ Consnsonwaaa o////aeeac Of Ici l UseOnly - `, I. 7 cc�� cc77 Permit No. t=s l rL3 r, 2).partm.ni o/,firs Serviced • ~ I ' 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 s.t ( C),527�CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: , ��s LI. City or Town of: YARM O UTH To the Ins.ector of Wires: By this application the undersigned gives notice of his or her intend ion to percorm the electrical work described below. Location(Street&Number) `, k .S'�t , .t LA„,, es�- I,tiKavu Owner or Tenant e l6c c Telephone No:4(g 113C Iola Owner's Address Is this permit in conjn`pction with a building permit? Yes ❑ No L� (Check Appropriate Box) * Purpose of Building tl6Mt Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work:eilvt.e, 00 0 w a. Completion of thefollowin&table may be waived by the Inspector of Wires. W No.of Recessed Luminaires No.of Cell.-Sasp.(Paddle)Fans No.of Total Transformers KVA Cl. No.of Luminaire Outlets No.of Hot Tubs generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. grnd. Battery Units `l No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones T No.of Switches No.of Gas Burners No.of Detection and Initiating Devices i Li No.of Ranges No.of Mr Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons __.-KW No.of Self-Contained Totals: `" Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 Munnection nicipt 0 Other 'art No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water tem KWNo.of No.of Data Wiring: HSigns Ballasts No.of Devices or Equiivalent 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 Val of ElElectrical Work: [,I,00 (When required by municipal policy.) Work to Start t. J $ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C RAGE: 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 a BOND ❑ OTHER 0 (Specify:) I certify,under thserins and pens es of perjury,that the inform,don on this application is true and complete. FIRM NAME_° ps tt_q*(1-‘ 1104 LIC.NO.: Licensee: ____ AIiIJ &Wit ki Signature i L..._..,_ pit t/Ml LIC.NO.: 0-73 �6� (/aapplicable,eke"f not' in thelrge�nse n bar line. Bus.Tel.No.: Ar(p 0 I� AR Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security wo ires Department of' blic 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. PERMIT FEE:$ 50-