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Home My WebLink AboutBLDE-22-006380 Official Use Only i-IjPermit No. BLDE-22-006380 i`co (..6\ Massachusetts Commonwealth of Tzers9 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:5/4/2022 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. �jj Owner's Address PO BOX 412,YARMOUTH PORT, MA 02675-0412 11��►`j`�" Is this permit in conjunction with a building permit? Yes 0 No 0 (C _� ��' ' / Purpose of Building Utility Authorization N Ni . Existing Service 60 Amps Volts Overhead ❑ Undgrd 0 , .. . f t New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service. 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 . Above ❑ No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ In-grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Ton No.of Waste Disposers Heat Pump I Number I Tons KW No.of Self-Contained Totals: Detection/Alerting Devices Local ❑ Municipal ❑ Other: No.of Dishwashers Space/Area Heating KW Connection Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or No. 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 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 LIC.NO.: 21302 Licensee: Walter W Kelly Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:7 MONROE LN,WEST YARMOUTH MA 026732731 *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 'PERMIT FEE: $50.00 I Signature Telephone No. av Wilt co II uOLtv rya s iP/ c- low -2 k�`` ry� / Official Use Only Commonwealth of Ifladaach ati4 J`j {� Permit No - 3:- '--.'i:-.;*."4 ei aUsparfmsnf o �irs Jartiices Occupancy and Fee Checked it,,nr i y �, 44 BOARD OF FIRE PREVENT{ON REGULAT{ONS [Rev.il07j (leave blank) qi APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK �� A All work to be performed in accordance with the Massachusetts Electrical Code(ME ,527 C 12.00 (PLEASE PRINT IN INK OR TI'P INFORMATION) Date: 4 City or Town of: To the Inspector of Tres: By this application the undersign gi es notice of his �Intention/' to perform the electrical work described below. Location(Street&Number) /d r ` it," Telephone Na. �j��`"d��J 1 Owner or Tenant A� � y Owner's Address A //,'e '� No El (Cheek Ap opriate Btox) Is this permit in conjunction with a building permit? Y� Utility Authorization No. (�7 e 1 Purpose of Building I, Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters .� New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampaciityy (o0,1�� D�� /) ... / Location and t+iature of Proposed Electrical Work: /_e � Tte -0i-A)1 CP /Z eac.Q.4,t_pit// Completion old;e.foltowinatable may be waived by the Inspector r of Wires. No.of No.of Recessed Luminaires No.of Cei1.-Soap.(Paddle)Fans Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators Above In- No.of Emergency Lighting Na of Luminaires Swimming Pool grad. ❑ 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 Total 'No.of Alerting Devices No.of Ranges No.of Air Cond. Tons Heat Pump I Number'Tons I KW 'No.of Self-Contained No.of Waste Disposers Totals:Ij Detection/Alerting Devices MunicipalOther No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ KW SecurityS�,stems: No.of Dryers Heating AppliancesNo.of Mvices or Equivalent atNo.of No.of Data Wiring: No.of W Heaters KW Signs Ballasts No.of Devices or rivalent TeTecommnnications No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices Equiv eat OTHER: Inspector of Wires. Attach additional detail if desired,or as required by the Estimated Value of Electrical Work: (When required by municipal policy.) � completion. Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon 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 ❑ OTHERd 0 (Specon¢n this ap Haitian is true and complete I certify,under the 'r ° r k ; i3��-`-C_ 1 �' ) Va Signature U9()t 0 `Vj- LL- LIC.NO.: Licensee: � us.Tel.No.; Of applicable.enter"exempt" t�e license number line ( t I�� t] /I CI Alt.TeL No.:T,,t ;" .. "'� 6 Address: �� r1� � 7r.+� actin License: Lic.No. *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safetyverage OWNER'S Ili ISURANCE WAIVER: I am aware that the Licensee es nIh (check am the the one)❑owneinsurancer❑owner rma ly ent. required by law. By my signature below,I hereby waive this requirement. � Owner/Agent Telephone No. I PERMIT :$ Signature it,