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Home My WebLink AboutBlde-22-002952 \\ Commonwealth of Official Use Only l' `� Massachusetts Permit No. BLDE-22-002952 w.' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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:11/21/2021 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 electrical work described below. Location(Street&Number) 30 MOCKINGBIRD LN Owner or Tenant Bill Horan Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. 7115738 Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement service&install bedroom lights w/dimmers. 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 2 No.of Gas Burners No.of Detection and Initiating Devices _.:L., No.of Ranges No.of Air Cond. Tn Total No.of Alerting Devices 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 Ballasts Data Wiring: Heaters Siens N9.of Devices or Eauiyalent „ , „_-__ No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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. NN 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 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: $50.00 49 <</ m, .k). -)yr 6 q��1/Amp tit lii-eal 7/A,f/71 t - ComnwnwaaLlh of Mamaslutostie Official Use Only c�� Permit No. '`E ;" a '; �Urpartinsnt o f..tire&rvscse `f *_`3t Occupancy and Fee Checked �, BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) (leave blank) qa APPLICATION FOR PERMIT TO PERFORM ELECT ICA WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),52 Ciii I 7d (PLEASE PRINT IN INK OR TY INFORMATION) Date: // " v City or Town of: 6�O U� To the Inspect° of Wires: By this application the undersign gr es notice of his or her intention to min the electrical work described below. Location(Street&Num r _ O MO C-eI�bi re./ L,✓ Owner or Tenant / � � Telephone No. O -86 Owner's Address 5/191 t Is this permit in conjunction with a building permit? Yes ❑ No a (Check Appropriate Box) Purpose of Building Utility Authorization No. 7//S7-561 s Existing Service Amps / Volts Overhead El Undgrd 0 No.of Meters —J New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: /OO 4— .0 'en c�-Q(b)IC"... iN`a�t"""6 3. -f- rig%�-2 t ,,,A-1-„I ( �? t =Dnc�,� c.„2.,',,,nue v(4i S /, ' 1i tat Completion of the following.table nt9.7 be waived by the&vector of Wires. Total No.of Recessed Luminaires No.of Cell.-S (Paddle)Fans To.of KVA °Sp• Transformers KVA No.of Laminaire Outlets No.of Hot Tubs Generators KVA .., No.of Lnminairea Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. grad. Battery Units No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners Na.of Detection and Initiating Devices k ' No.of Ranges No.of Mr Cond. Ton` No.of Alerting Devices No.of Waste ce Heat Pump Number Tons �_KW 'No.of Self-Contained Totals: '__ Detection/AIe�Devkes No.of Dishwashers Space/Area Heating KW Local 0 Connection 0 Other No.of Dryers Heating Appliances ' Security f Daum or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Egiuriivnallent tmkations No.Hydromassage Bathtubs No.of Motors Total HP T elecoof Devcees or EEqWeivalent 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: 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. — K ONE: INSURANCE J BOND ❑ OTHER 0 (Specify:) Cl r--.--tl-----,5.I ' ,under the and na o+��wry, the information an this application is true and complete. / /� I�9 -' NAME:�,�1 U�� QC�/ 1 C t C A I L/U LIC.NO.: p2/3 "7 �u N rises: w c e �ti Signature j Dal �'U 1 ell-A—' LIC.NO._5l<��f F l plicable,enter'exempt"Ore license awn line. vv �i us.TeL No.: • �� Ll<k .- dress: , /Y-9t 1 L 7�"i t.TeL No.: „�(40 * r M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. 0 O zO ER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally ill Z Jr ' by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. �°°"`` -" :filar' Telephone No. PERMIT FEE:$ j ai