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Home My WebLink AboutBLDE-21-007589 orw- Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-007589 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:6/29/2021 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) 22 SHEFFIELD RD Owner or Tenant Kenya West Telephone No. Owner's Address 22 SHEFFIELD RD,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check AptQ Iy •'' Purpose of Building Utility Authorization No. -�'• •7 �/ Existing Service 100 Amps Volts Overhead 0 Undgrd 0 ''o 1 •to '400 i New Service 100 Amps Volts Overhead 0 Undgrd 0 A -- tiff . .. Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service. 4,4 lir Completion of the following table may be waived by the ,4 si Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Tot 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 Initiatinc 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 ❑ 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 Siens 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: LLOYD R SMITH Licensee: Lloyd R Smith Signature LIC.NO.: 15688 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 1ST ST, MELROSE MA 021764010 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 '//3(u kg- / C..onuiwawean of///ai6ac1ueth Official Use Only " t - m Permit No. t '7 9 1 "- Apartment o`Sire�ervicei i+ -:.f Occupancy and Fee Checked ''r< BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECT ICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC . CMR 12.00 (PLEASE PRINT IN INK OR TYPE L INFORMATI ) Date: .. .. I City or Town of: �m(J ( J To the Inspector o Wires: By this application the undersigned gi s notice of his or her intention to perform 1I- electrical work described below. .. Sh Location(Street&Number) � ic�k ' I o� �i Owner or Tenant IL - r RIM Telephone No �, qQ 1 d Owner's Address S — CIA I n‘ Is this permit in conjunction with a buildinpermit? Yes ❑ No (Check Appropriate Boa Purpose of Building (j'.,.Jt[ tUtility Authorization No. �� 1 (Q Existing Service(CC)Amps 1ZC.r 24,3)%--S Overhead . Undgrd❑ No.of Meters New Service 1 C6 Amps 12-C.)i7.4.. is Overhead (Undgrd❑ No.of Meters ' Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (LjC ci1/4_,(N) sei V l Completion of the following table m97 aived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Total p Transformers I VA 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 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 Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 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 Systems:*Mmonnecunicipalon 0 Other No.of Dryers Heating Appliances KW 1SecNo of Devices or Equivalent No.of Water , No.of No.ofKData Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Equivalent No.of Devices or Equivalent OTHER: cj Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work:2.25-1s • (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 overage 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 t_he painns a ,pe , i' perjury, a tnfor anon on this application is true and complete. FIRM NAME:v 1 v`Y\'- 61 thq & • - �_ LIC.NO.: Licensee:` E. Sty, I \ Signa c �lleW (If applicabl ex mpt"in the lic•, e number line.) et.,. - Bus.I el.No.:� ( Address: •A i i ._411i./.41 .ak /A— a .1 sal". •. TeL No.: �'f r Z-s '7 *Per M.G.L.c. 147,s.57 ,1,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 insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Agent I PERMIT FEE: $ Signature Telephone No. rn(1 ✓ • CV IDretb-' -C Q SUh Ian • w t