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Home My WebLink AboutBLDE-21-007539 or Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-007539 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:6/28/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 223 ROUTE 6A Owner or Tenant FITZGERALD SHEILA M TR Telephone No. Owner's Address SMF REALTY TRUST,223 ROUTE 6-A,YARMOUTH PORT, MA 02675 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 ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Feeder to shed on patio&wiring. 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 1 Swimming Pool Above 0 In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 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/Alertine 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 1 KW 1 No.of No.of Data Wiring: Heaters Si2ns 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: Brian R Kilroy Licensee: Brian R Kilroy Signature LIC.NO.: 29376 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:66 SWIFT BROOK RD, S YARMOUTH MA 026644040 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: $100.00 `'rd cc&wer (.0(.0q7_4 -a t3 CE► ccc ci i_ _� �yy� COANIIOI1101/t(A Ol///aeeaciiWestle Official Use Only - ., ti Permit No. ‘' .-'2-k-7 53? e, 2eparti sent 0/ L&wine I ' • '; Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1107] (leave blank) 1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 2 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: Z Z. i City or Town of: �f Qsk To the Inspec or o Wires: By this application the undersigned gives notice o or her intention perform the electrical work described below. Location(Street&Number) Z23 CP/J/4 P,/4 Pi 64 > Owner or Tenant A I'tj ` / Telephone No. 77�f-f�Q f'• 73/j Owner's Address /-. /D�iTG= 6 4 YYkL '&ce% fdB4Ef/7,4,- 0.7-,6 '6 Is this permit in conjunction a building permit? Yes No [� (Check Appropriate Box) Purpose of Building S.1.4 Utility Authorization No. Existing Service V Amps /22 /?car-Wolfs Overhead 0 Undgrd❑ No.of Meters __Z__ .1 New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters • Number of Feeders and Ampacity 1 Location and Naturp.etf Proposed Electrical Work: +,,,t e.ii / (n? Fri I- .S(15,0 •, .,%ocdl--? i,.J P.41-CO Completion of thefoiowinstabk may be waived by the inspector of Wires. -b No.of Recessed Luminaires No.of Cell-Sup. Fans Tran Total "��(Paddle) Transformers KVA S' KVA c1 No.of Luminaire Outlets No.of Hot Tubs Generators Above In- No.or Emergency Lighting k No.of Luminaires ( Swimming Pod grad. ❑ sand. ❑ Battery Units No.of Receptacle Outlets t No.of OB Burners FIRE ALARMS No.of Zones No.of Switches l No.of Gas Burners No.of ting Devicesction t:.+ No.of Ranges No.of Air Cond. Tod No.of Alerting Devices No.of Waste Disposers 'Rest Pump Nt�nber..Too:..._KW NDe ofeSelf-Containedn/Alerti D evices No.of Dishwashers Space/Area Heating KW Local 0 Colel0 Other No.of DryersHeatingAppliances KW �' Security No.oDevices or Equivalent No.of Water No.of No.of Data Wiring: Heaters- KW 1 Signs Ballasts No.of Devices or Equivalent _ iring: No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNofDevices q y � No.of Devices or Equivalent OTHER: Attach additional detail if desired oras required by the Inspector of Wires. Estimated Value of El 'cal Work: 2j, Dca (When required by municipal policy.) Work to Start: Z) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO 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 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of pedstry,that the ii.foraraalon on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: /3e,Ar) teip8j Signature 7-45„,,,,..-- LIC.NO.: L2j37la (If applicable,enter"exempt' in the cense number line.) Bus.TeL No.. Address: Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability i ce coverage normally required by law. B my signature below,I hereby waive this requirement. I am the(check one)[owner ❑owner's agent. Owner/Agent , / Signature ,/J�1. Telephone No.`7(Y' 9,7 PERMIT FEE:$ /00f" 73/,7