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Home My WebLink AboutBLDE-22-007440 Commonwealth of Official Use Only . ,Ali Massachusetts Permit No. BLDE-22-007440 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:6/28/2022 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) 101 WEIR RD Owner or Tenant MASI RICHARD E Telephone No. Owner's Address PO BOX 412,YARMOUTH PORT, MA 02675-0412 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 ❑ 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: Split NC&exterior receptacle. 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 1 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. 1 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW NoNo.of Self-Contained lf-Co Detection/Alerting Devices Totals: 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 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: 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 && i l Y k 4 �.. V Commonwealth rr y�j / IZJ o�/�IaddatiuedaEtd Official Use O"a'l�ZZ L z...- -. -,..-,,-.44tp c-�� Permit No. -'— / ` 0 2apartane►d of ire Serviced }_ Occupancy and Fee Checked ,.... ' �: �Y� BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 2,1 All work to be perforated in accordance with the Massachusetts Electrical Code(M ),552/7 C 12.00 J I (PLEASE PRINT IN INK OR TYL' INFORMATION) Date: 6 / City or Town of: To the Inspector of Wires: By this application the undersign gi es notice of his or her intention to orm the electrical work described below. I Location(Street&Nti er) I 0 i (� ill C Owner or Tenant 1^et L 1( C k "/f -"3/ Telephone No.5 )l 7 4e 7 07.5/ — Owner's Address 514,,, �- — P et IT15 p A Is this permit in conjunction with a building permit? Yes 0 No ,►mil (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters �--� New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity ,_ Location and Nature of Pr Electrical Work: )i N 6 [5 F ;j Z�-C fit" S/i%~/ il}k 4'. 3 4-e - 4 . e>tr Cr)d r /v /got .,28 C etion of the followingta le may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No. Trr anan KVA of Celt-Slap.(Paddle)Fans Tf KVA sformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires gym p_l Above In- No.of Emergency Lighting g and. land. ❑ 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. Tones No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices CO No.of Dishwashers Space/Area Heating KW Local❑ MuIIneetiOnnicipal 0 Other 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 E< <' alent No.Hydromassage Bathtubs No.of Motors Total HP 'I'decommnnfcations i 1 No.of Devices or Equiv, nt OTHER: Attach additional detail rfdesired,or as required by the Inspector of Wires. Estimated Value o El ' al Work: 4-6D" (When required by municipal policy.) Work to Start: b Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C 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 J BOND 0 OTHER 0 (Specify) I certify,under the ' and enahi of p , the information an this apglation is true and complete.. / FIRM NAME:Lk tt E t S 4 Cz C r 1 Ci C ) _tit,C . LIC.NO.: , /3 2 Licensee: Ul\t 1 Signature( Qp�l 0 V 1 - LIC.NO.:57/37// Of applicable,enter"exempt" a license number line.) , v ,t „ us.TeL No.• Address: 7 t�l�} -O ,�1�- ( 1L�U 7 1 /_� %AYt.TeL No.: 5C)f i'#- 5(f i --GeV/ *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 insurance coverage normally required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner'sagent Owner/Agent Signature Telephone No. PERMIT FEE:$ 6