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HomeMy WebLinkAboutBLDE-21-004849 Commonwealth of Official Use Only ! Permit No. BLDE-21-004849 ��- ,,� Massachusetts 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:2/26/2021 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) 61 ALM IRA RD Owner or Tenant ELSDEN MARION P TR Telephone No. Owner's Address M E P REALTY TRUST, 90 NORTH STONE ST,WEST SUFFIELD, CT 06093 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: Master powder room. 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 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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 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. �l��0/ n CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) S191 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. 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 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: $75.00 (C4S % a) /!/z1 1(1‘itk(,/ (A /A,. {l �1�� �,e1, l/ -1C-or i;J c- ,vw ©n F- ,'ion c c., r r s I Ai cerl4 4 -4 -3 o evP C ; s --/-- r..e - r_rf ,� �p f` 5e_e C'E' O)(-i i" C.mmor.weaw1 01a4acnusetti - _- Official Use Only `� ,,,,,__-F �- �,',[r-�� Permit No. �'4. 6(-11 . tel- . _ L)epartmsrt 0/../ins S' 1 _ Occupancy and Fee Checked - = =_ - BOARD OF FIRE PREVENTION REGULATIONS 1/07J (leave blank) APPLICATION FOR PERM T TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(IEC)," CMR 00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: ;2 / g City or Town of: YARMOUTH To the Inspector of Wires: . _ By this application the Imdersigned gives notice of his or her intention to perform the electrical work describedb w. Location(Street&Nu•,t ) / 1/2414 ) 12 i S ',�4 i"'A c) ;4^ Owner or Tenant G 1 E/"Sile AZA Telephone No�0 S Owner's Address /Tri rid, sc)f t*- C.:1— OCC 7E 4...C6 -- Is this permit in conjunction with a building permit? Yes, No ❑ (Check Appropriate Bar) Purpose of Building Utility Authorization No. Existing Service Amps I Volts Overhead Q Undgrd 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ Nti.of Meters Number of Feeders and Ampacity tion and Nature of Proposed Electrical Work: ‘4,11`i"i/vtl44 Of New (14/1-3 rem j r`- AJL)-fir //ZOOM—— /rte/L/ G > I —$co&'C.€ 1' ✓�N/T Y PL L1 JAI � • Lmnleeion of the following table may be waived by the Avower oftW rs. No.of Recessed Luminaires No.of CeL-Sirsri. ransformers (Paddle)Fans i. a.of W KVA No.of Luminaire Outlets 1No.of Rot Tubs 'Generators KVA k.,) No.of Luminaires Swiamiag ?aoI9.bc:ze 0 Itntrtaot.toefrit neirtgseacp Lagating .r No.of Receptacle Outlets No.of Oil Burners LARMS No.of Zones `-) No.of Switches No.of Gas Burners No.of Detection and Cli Initiating evices t 1 i No.of Ranges INa.of Air Cond. T n N.o.of Alerting Devices No.of Waste Disposers Heat TORS No. ``Tons !!KW No,of Self-Contained Totals:I 1 I Detect anlAierting Devices � No.of Dishwashers f 5pacelArea Heating KW' Loral Q Conn or 0 Comer No.of Dryers 'Heating Appliances \� No.of Devices or Equivalent _ No.of Water , (No.of No.of Data Wiring: Heaters { Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No_of Motors Total gp Telecommunications V�irin�: ' No,of Devices or Equivalent th OTHER: • - Attach additional detail tf desired or as required by the Inspector of Wirer, -, 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. 1 INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue=less the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent The undersigned cues that such coverage is in force,and has exhibited proof of same to the permit issuing omce. CHECK ONE: INSURANCES BOND 0 OTHER 0 (Specify:) I certifp,ander the pains and penalties ofperfy,that the r rmation on this application is true and complete. FIRM NAME: b 'Net I ;^ , . _ U; -erk-it 1 N ) TA)C. LIC.NO.: ,3/3 a, /4 Licensee: (;per i4-C'.r kQt 1,. gnature (A')t Q. //.eidit ;— LIC.NO.:t7.j P- 3 (Ifapplicable.enter'arempt"in the liceritie cumber e.) _ Bus.TeL No.: - . Address. LA t'')A) e2..-Q t _ CT ' ('/t-r, A LAI''‘,- 1F/ Alt:TeL No.:.fRPc1' 20- s l( 1 *Per M:G.L.c. 147,s.57-6I,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)0 owner 0 owner's agent. Owner/Agent I PERMIT y�y� @ �ry if Signature TPIPnhemx P.M - FEE:_ �U � �, /.�~