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Home My WebLink AboutBLDE-22-006005 Commonwealth of Official Use Only - glIPIK � ►0 Massachusetts Permit No. BLDE-22-006005 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:4/19/2022 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) 2211 HEATHERWOOD Owner or Tenant SCOTT CHESTER T JR Telephone No. Owner's Address SCOTT MARDRIVON D, 2211 HEATHERWOOD,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 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: Replacement roof top disconnect(UNIT 2211) 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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ton No.of Waste Disposers Heat Pump Number Tons J 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 Ballasts Data Wiring: Heaters Siens 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: KELLY, MCKENNA AND DAVID ELECTRICAL CONTRACTOSR, INC Licensee: Connor K Tilton Signature LIC.NO.: 22722 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 5083178885 Address:398 Court Street Unit 3R, Plymouth MA 02360 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $80.00 obq ofrz.,r15: . ".F np Official Use Only C,ornowwes o`/�/ Permit No.l%-' i .m v �a�, ,,,t ` ',.�.,wic a Occupancy Fee Checked •OC' BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] leave blank APPLICATION FOR P IT T - F• R ELECTRICALWORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),S MR 12.00 Date: 4 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) To the Inspector►y 2 20►�• Wires: City or Town of: �c.Y inn Q,A1—• �the electrical work described below. By this application the undersigned gives notice of his or her intention to perf Location(Street&Number)_ %OO W-e wkN.,r 3 c a c - `/c.r ret J ' Owner or Tenant V In A. # 'au Telephone No.Sb%-3t1-%€ Owner's Address 0 N (Check Appropriate Box) Is this permit in conjunction with a building permit? Yes Purpose of Building ( See Utility Authorization No. Existing Service____ Amps / Volts Overhead 0 Undgrd 0 No.of Meters Dje _ Amps / Volts Overhead 0 Undgrd 0 No.of Meters _____, Nambar of Feeders and Ampadty Electrical Work: }- o C s' 1 ►�►,c 0 P �i(e Loeaf on and Nature of Proposed CL�Q�c.c cJ+n�,r+ A\Sl-c-w.v.n cI-S \n 4-Q*111 Completion of the followi table mg be waived by the Inspector of*Ws Fans Total of No.of Recessed Luminaires No.of Ceti.-Snap.(Paddle) No. KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA o.o 'mergency 7, ; ,g No.of Luminaires Swimming Pool ,, ,Are e ❑ n-d. ❑ Battery Unit No.of Oil Burners FIRE ALARMS INo.of Zones Na of Receptacle Outlets o.of Detection and ' No.of Switches No.of Gas Burners Initiating Devices Total Na of Alerting Devices No.of Ranges No.of Air Cond. Ton: Heat Pump!Number(Tons JKW....._... o.of Self-Contained No.o''Waste Disposers Totals: T DetcctbdAlerdnfl,Devicea Na�of Dishwashers Space/Area Heating KW Local 0 Matron 0 Other Security System s: Na of Dryers Heating Appliances KW Na of or Equivalent No.of Water No.of No.of Data Wiring: KW BallastsNo.of Devices or '-,ulvalent Heaters S ' s Telecommunications ' No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Eu ,t OTHER: Attach additional detail if desired,or as required by the Inspector of Wit 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. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unle 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 ❑ OTHER 0 (Specify:) I cm*,under the pains and penalties of pedury,that the information on this application is true and complete. FIRM NAME:--ri**or. Eio c)t r i L 2 r,L LIC.NO.:aaa"1-aa-A Licensee: Q AD+nr.or--1-7\din S a >tore C_. LIC.NO.:__,___T_ (If applicable,enter"exempt"in the license number line._, Bus.TeL No.: %-31)-h?Ys Address: 3ct a C ,r-E' - ruzsA,- -` ant m c, 6 a'3b11 Alt.Tel.No.:_� r ` 1 I ent of SafetyPublic "S"License: Lic.No. epee M.G.L.a 147,s.57-61,security work requires OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage noimill required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's ag pruner/Agent Sianatnre Telephone No. I PERMIT FEE: 4