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Home My WebLink AboutBLDE-22-004441 a 4A k 8 N-k Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-004441 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:2/9/2022 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 descr' below. �� Location(Street&Number) 147 THACHER SHORE RD f `I 14�____ t :: Owner or Tenant Telephone No. Owner's Address 147 THACHER SHORE RD,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: Miscellaneous work per attached. 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 Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ 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 Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: 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 my signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$50.00 st , El ( .�_ .y o - u` l( cet // /�-.' OD� ___, 1 Commonwealth of f7aosae/utefita Official Use Only - , * r _t �'] Permit No. 72- `ig (.( v: F f !!f/Ji O ,}{nf Serfdom. BOARD OF FIRE PREVENTION REGULATIONS Occupancy y and Fee Checked �' s,.� [Rev. I/07j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL ORK ,�� All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 2.00 "--�"'( (PLEASE PRINT IN INK OR TY INFORMATION) Date: /�6�� J City or Town of: �Q( To the Inspector of Wires: By this application the undersign es notice --oyyf--his or''her Intention toperform the electrical work described below. Location(Street&Number) L�1�LlL� •o" itA Owner or Tenant (jam e 7--'3� �j r c k t -.f.� � Telephone No. 7 f- (p �I'ro -O 79S' -- - Owner's Address .2om r,.r Le 6 noU 9 o' i-cl O/-7 1 I Is this permit in conjunction with a building permit? Yes 0 No E— (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undg rd grd❑ No.of Meters "-: ' New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: f?j c - l 00 '� ft94��, (f,c 1 1 t'oo P-c-' 4"`- 7r/S�?I l 02 6 a1 t ,�� - -2-Af 5"TAL 4-q I l /Wf KI .—(� GA- —i4-rd�� N P � Ja- t9E.�—w0cQ Completion of the following table m be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cam.-Snap.(Paddle)Fans Tr` � a To. KVAformers k ti'tZf�^ I No.of Luminaire Outlets No.of Hot Tubs Generators KVA PLl)J 5 No.of Lnminair ea Swimming pal Above ❑ In- ❑ No.of Emergency Lighting grad. grad. Battery Units -(i.�cki►'\ No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones doer V ¢d No.of Switches No.of Gas Burners No.of Detection and t,,t l'l.L e Initiating DevicesTotal ,1dAA. No.of Ranges No.of Air Cond. Tons No.of Alerting Devices S LA/i No.of Waste Disposers Heat Pump Number Tons __KW. No.of Self-Contained Totals: _� Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑ Munectionicipaln ❑ other Con 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.Hydrotnassage Bathtubs No.of Motors Total HP Telecommunications W e- / No,of Devices or Equivalent OTHER: &.t i. 0 -i- 5I(J iL e i 5 ter.4-cko ) Attach additional detail if desired,or as fequr•red by the Inspector of Wires. 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 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 J BOND 0 OTHER 0 (Specify:) I cernfy,under the paltis and pe o uty, t/ie hrfoa matron gn this a tication is true and complete. FIRM NAME: ( l Q �xy ` Q( t C c e, LIC.NO.: 2/.3 O2 '9 Licensee: Gla \to Signature 114�"'Qi 0(Ifapplicable,enter"exempt fi7itelicense number line. t�1 Tel. o• _ l j Address: W. (/Lfr l L4 ut Tel.No.: - ----G417/ *Per M.G.L.c. 147,s.57-61,security work requires Department of Pu lic 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 Signature Telephone No. +PERMIT FEE:$ (0