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Home My WebLink AboutBLDE-22-002951 Commonwealth of Official Use Only fil IN Massachusetts Permit No. BLDE-22-002951 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:11/21/2021 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) 66 NORTH MAIN ST Owner or Tenant CAMPBELL DOUGLAS A Telephone No. Owner's Address CAMPBELL HEATHER A,66 NORTH MAIN ST, SOUTH YARMOUTH, MA 02664 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 Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 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 Initiative Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine Devices i Space/Area Heatn Local ❑ Munici al No.of Dishwashers P g KW Connection 0 Other: HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. a Estimated Value of Electrical Work: (When required by municipal policy.) y' 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. 'PERMIT FEE: $50.00 I e q,, 12,,,vk. O `� /% // `�`t/, - � r (Npe�-' Commonwsattdi cif t`7laaeacliueatio Official Use Only f• lit Lt c� Permit No. "'2L— Z/c' "i al arartmsnt o/. ,vices '. fit BOARD OF FIRE PREVENTION REGULATIONS1/0 Occupancy and Fee Checked ,� [Rev. 7) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRIC ' L WORK All work to be performed in accordance with the Massachusetts Electrical Code(M C 27.` /i I .1' I(PLEASE PRINT IN INK OR INFORMATION) Date: % '=Q /�.'° ' 11 1 t I.Ai �J City or Town of: MC U T To the In r of Fires: By this application the undersign gi es noticf of his or her mtention per,fonn the electrical work described below. Location(Street&Number) L..ef /[/e dl-t t✓ I _5 ` c.nk Owner or Tenant 00p v ci 1/,./hyi Telephone No.5O 280 7 goc — = Owner's Address 0 F g Is this permit in conjunction with a building permit? Yes 0 No (Check Appropriate Box) 1 Purpose of Building Utility Authorization No. __ Existing Service Amps I Volts Overhead El Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters O Number of Feeders and Ampaclty G , Aedth 4Location and /�Nature of Proposed Electrical Work: W t n.-e r S r/ � S CA)t 7Yit, b Z/ ce/(4-- 1-D 4/ LIG -c ,L el6 s�4-s(AAI G-iy�7, DI St oW(I p/4) C/!7 �t5-1 rt_pe, tb ..F(b M ,. Completion of Me following table may be waived by the lector of Wires. No.of Total No.of Recessed Luminaires No.of CelL-Snsp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- I-, No.of Emergency Lighting fund. grad. Battery Units ~ No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and `` No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Tans '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❑ Coanneefibn ❑ Other No.of Dryers Heating Appliances KW °gecNa o y f Devices or Equivalent No.of Water KW No.of No.of Data wig. Heaters Signs Ballasts No.of Devices or Equivalent No.HydromassageBathtubs No.of Motors Total HP Telecommunications Wig'rig No.of Devices or Egnlvalent 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: 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. K ONE: INSURANCE J BOND 0 OTHER 0 (Specify:) CI I ereify,under dt elAV �annd�nalti a uty, the information 4tn this a lication is true and complete. / i! '' NAME: "t`V W� 1� CLC,,.'r 1 ca C� C, LIC.NO.: al/. &2 Q.,, o v censee: W Signature LIC.NO.:`�,,qq �\to t ��- 3 `'' c� ( applicable,entertt"exempt" The license number line. �A us.TeL No.: r t La.. ddress: 7 I� /S-� i r('�YLIF 1 V t.Tel.No.: �C, K^- ---(o ; 1 O er M.G.L.c. 147,s.57-61,security work requires Department of lic Safety"S"License: Lic.No. Ci o Z WNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally ice? Z uired by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agent. 5 er/Agent PERMIT FEE:$ U co gnature Telephone No.