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Home My WebLink AboutBLDE-21-004018 Massachusetts'�Commonwealth of Of Use Only Permit No. BLDE-21-004018 �E `� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.l/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:1/21/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 116 EXETER RD Owner or Tenant Richard Killroy Telephone No. Owner's Address 116 EXETER RD,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: Convert garage to living space. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 10 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 Lightin grnd. grnd. Battery Units No.of Receptacle Outlets 4 No.of Oil Burners FIRE ALARMS No i f nes'', l No.of Switches No.of Gas Burners No.of Detection an, +.:. 4.. Initiating Devices No.of Ranges No.of Air Cond. TotaTons No.of Alertin t evi s ':.41 ,.• l,'- '•'yam Heat Pump Number Tons KW No.of Self-Con • �ecr;,/ �,( "y No.of Waste Disposers ! , a�r Totals: Detection/Alerting . vic�g,.y �O�r No.of Dishwashers Space/Area Heating KW Local ❑ Municipa EY6', othef: Connection t ,›. No.of Dryers Heating Appliances KW Security Systems:* \,?:, No.of Devices or Equivalent .No.of Water KW No.of No.of Data Wiring: N 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.(e (7-9)68-® 68 J Q Z FIRM NAME: Justin W Morehouse Licensee: Justin W Morehouse Signature LIC.NO.: 52679 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 PINE ST, BERKLEY MA 027791111 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. FERMI' IMIll 2141414of f (Alt. Poio f r 21/6(st ' (12s-ii: 1 °� -lam pto0-113) C -.(Mgp 0/1,9 1 1 8(74 CE__ 91( W _ _ - - - official - Crnervaa 0/ pmadead4'~ Use Only { c•� �1 Permit No. e� - C 0t v Occupancy and Fee Checked - r,, , BOARD OF FIRE PREVENTK)N REGULATION [Rev.I/073 (leaveblank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK AU work to be performed in accordance with the Attu Electrical Code. C`),527 CMR 12:00 (PLEASE'PIWIT I1V INK OR SPE bV ORMA ON) Date: I/I f •d Ciily or Town of: ,4 'u/hits f. To the I for of Wires: By this application the undersigned gives notice of his or her mtention to perform the elaotrical work described below. ' Location(Street&Number) • r J ' t Owner or Tenant W(C:�‘,, k-,i{(oy `Sk Telephone No.917 _76/ -91X); Owner's Ams t 1 E. R v . t. AIN Is tide permit ht combined..wit..inditlimg perms? . Yes **II No 0 (Check Appropriate Box) psrPem ofBudding T \t n Utility Authorization No. Existing S i„(11;) Amps t:a o / ago Volta Overhead cg/ Uodgrd 0 No.of Meters rim Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Aempad v Local mon dela Nita"ofPropoaed theories'Work: .T.....,,,rh( rit_ C"ii w -d dV L°✓ ?a IP611 ) v" C leti n°fthe;}ollowlq lableo be waived by the I+Tof*Vex lit No.of Recessed Luminaires airee 1 6 No.of Celt.-Snip.(Paddle)Fans 1TVrssseora KVAI 4 No.of Inc Oudot* No.of Blot Tubs Generators KVA Ligstrag No.of swimming Pool Above ❑ In" L rfo.et-Emergency Unit* grnd. orad. �Unite . ` No.of Accepted*Outlds1 No.Qf OtI Burners ,FIRE ALARM'S No.of Zones VNo.of:Dete etion nod F , No.of No.oCr.as Bur Deskes t'4 No.of Ranges ,No.d Air Coate. Totalens vNo.of Alerting Devices Noe oe Woke mimeos Hues -!limber Totab: _Tam, IC_ - N S nes No.of Dbitwashan Space/Area Batting KW 1 roceal 0nMilincil"" ❑ Over H qt .s Ne*° ryatrt Ap res ' No.of3lD�av i or est No,efWater Ilei' No.of No.of wiring; Heaters Signs Ballots No.of es or. , No.Hydrne Batlsubs �No.of Motors Total HP T --- Na.of Devises or :. O"fRERr .haulm additional detailVand oras required by the hcspees&of Wires. Estimated Value of E • Wim:Ai 0 U men required by miipalpolicy) work to Start: ► /1 141 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE GE: Unless waived by the owner,no permit for the performance of electrical work may issue tudess the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent The undersigned certifies that succh coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND 0 'OTHER 0 (Specify:) 52.1,-`7 9 /ervitfy,antler the p nrisni of that the*formation on deb application is trim and complete. if FIRM NAME: 5'.,t1. o ft OLIC.NO.: <a1.,7 Licensee: S +R it o rtoff( sure \r,, v......_ LIC.NO.: (ffaMtlicable,enter"fit"f to the(kerne number t ) li Bus.Tel.No.: Address: C I Ge I the�l 1 rfl/ C41 (" Alt.TeL No.: s workrequires t of blit Safety"S"License: Lie.No. Per M.G.I.:c. 147,x.57-61,security Department 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)iJ owner 0 owner's Mut Ail I PERMITFEE:a Telephone No. 1 3 C