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Home My WebLink AboutBLDE-22-004572 Commonwealth of Official Use Only E` 1 Massachusetts Permit No. BLDE-22-004572 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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/N INK OR TYPE ALL INFORMATION) Date:2/17/2022 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) 122 WATER ST Owner or Tenant Michael Hagerty Telephone No. Owner's Address 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Service change from 0/H to U/G. 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 god. 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. Ton l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: _Detection/Alertina 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 Ballasts Data Wiring: Heaters Signs 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 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 17» v-- - gi etsccAici'�' l,)a : {, o Z3sZg R_E__CEIVEDI GI Id w o .4 Lire clt ) FEES 16 2022 „ CommonWea&O`///aaachueettd o lay d V@�t HA I<I M 1=N- partnuud o`.}ire Serviced Permit No. t�7�r i(� Occupancy and Fee Checked t 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.`` MEC),527 C1�R 12.00 S (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:Lick �� 121._ City or Town of: YARMOUTH To the Inspector of Wires: 5 By this application the undersigned gives noti e of his or her int lion to Location(Street&jJ i � _ � perfo the electrical work described below. oatOwner or Tenant .E Telephone No. *'}�Zl L� v 1 Owner's Address Is this permit in conju on with a building permit? Yes 0 No Z Purpose of Building �b Nl� 0 (Check Appropriate Box) • j Utility Authorization No. Existing Service Amps 2 /t1u Volts Overhead ✓❑' Undgrd❑ No.of Meters Z New Service Amps l4v / W. Volts Overhead 0 Undgrd g No.of Meters tzs Number of Feeders and Aropadty I Location and Nature of Proposed Electrical Work: cau iw u c �Clk vl `t� Completion of thefollowingtable m be waived by the/►vector of Wires. No.of Recessed Luminaires No.of Cell.-Soap.(Paddle)Fans No. sfo Total �t No.of Lurolnaire OutletsTransformers KVA 42k No.of Hot Tubs Generators KVA' No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting '�' No.of Receptacle Outlets � �Od' gLrnd. ❑ Battery Units No.of Oil Burners FIRE ALARMS �No.of Zones ti No.of Switches No.of Gas Burners No.of Detection and 1 No.of Ranges Initiative Devices g No.of Air Cond. Toms Tons No.of Alerting Devices No.of Waste Disposers Heat Pump umber Tons KW No.of Self-Contained Totals: ....______....._.... ....._.�. Detection/Alerting Devices No.of Dishwasher, Space/Area Heating KW Lori❑ Municipal No.of Dryers Heating Appliances KW Security Systemsn �� No.of Water , No.of No.of Devices or Equivalent Heaters Na.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring; OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: I(? Attach additional detail if desired,or as required by the Inspector of Wires. (When required by municipal policy.) Work to Start: IL c4, 2-1- 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 cove ge is in force,and has exhibited proof of same to the CHECK ONE: INSURANCE a BOND ❑ OTHER permit issuing office. I certify,under t sya n . ❑ (S ify:) gtrpe •es of pedury,that the inform on o this a plication Is true and complete. FIRM NAME: 1R a ,i N //�� LIC.NO.:— Licensee: �[7ALA--th `lk1-t/+N Signature /V"' *"'i'' LIC.NO.: (lfapplicoble,enter"exempt"in the license number line.) Address: Bus.Tel.No *Per M.G.L.c. 147,s.57-61,security work requires Department Public Safety"S"License: Alt L c.el.NNo o..: OWNER'S INSURANCE WAIVER: J am aware that the Licensee does not have the liability insurance coverage n�— required by law. By my signature below,I hereby waive this requirement. I am the(check one • owner ■ owner's a:ent. Owner/Agent Signature Telephone No. P PERMIT FEE:$