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Home My WebLink AboutBLDE-22-002512 or Commonwealth of Official Use Only >t�` Massachusetts Permit No. BLDE-22-002512 17 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:11/2/2021 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) 50 NEPTUNE LN Owner or Tenant Andrew Gallagher Telephone No. Owner's Address 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: Rough&final for kitchen&bathroom. 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- ElNo.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 Initiating Devices No.of Ranges No.of Air Cond. Ton l 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 ❑ 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 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Charles P Gallagher Licensee: Charles P Gallagher Signature LIC.NO.: 35141 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 15 West Ave, Spencer MA 015622927 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: $75.00 - 4- "I3I1-t &,)46, 4 012A47 2?)/ - I� Bar. V G 1 v G V e-nvl ct is( 'J f3 U Vcln C.€ NOV 02 2021 I.-c Bill I , AR1MENT Commonwealth-[�j --•-,;,,.,.,,, 7 rr/aeaachuesfte Official Use Only ,' �.r. _=`�t Pc �s Permit No. f!✓�' 2SI7i partmsni ol..c�irs Stallion, S� "1`I' Occupancy and Fee Checked ,, BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07J U (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C C) 27 CMR 12.00 _ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,/a p,?// City or Town of: YARMOUTH To the 1 spe or of Wires: N By this application the undersigned gives no is of his or her intent' to perform the electrical work described below. Location(Street&Number) d Owner or Tenant ! ;.? Ac a ,ty.-� Telephone phone No. 5d -,,6o��O/ s fl Owner's Address // g /'i�ry p r p �v� �J �.� Is this permit in conjuncts wi a b lding rmit? Yes 0` No '� Purpose of Building �rl ❑ (Check Appropriate Box) , e 4 M/yy Utility Authorization No. ��_ Existing Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead � El Undgrd❑ No.of Meters v Number of Feeders and Ampacity r Location_a3�d Nature of Proposed Electrical Work: �� K ,r 7/ p / l7/SfJ `/V�,'/y7� /ti/f�ti'i'1 slu• r Completion of the followin&table m be waived by the Inspector of Wires. E!. No.of Recessed Luminaires No.of Cell.-Sns . No.off Total p (Paddle)Fans Transformers C.1 No.of Luminaire Outlets KVA ,�� No.of Hot Tubs Generators KVA t No.of Luminaires Swimming Poo[ Above ❑ In- No.of Emergency Lighting gird. grad. 0 Battery Units �` No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones ,_ No.of Switches No.of Gas Burners No.of Detection and i•r Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons KW °No.of Self-Contained Totals:I Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal No.of Dryers Heating Appliances KW Security Systems:* on ❑ other No.of Devices or Equivalent No.of Water No.of Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of 1 trical Work: /dO0 (When required by municipal policy.) Work to Start: a / Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE 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 $1 BOND 0 OTHER 0 (Specify:) Pe fY:) I certify,under the pa s and penalties of perju ,that ij lnformytrion on this application is true and complete.FIRM NAME: / jCs/� (cif �d/ �/� C/f T l G 'G.� Licensee: y LIC.NO.: r �4 ) 't' Signature IC.NO.: (If applicable,ente ex pty' �the lice a number line. Address: J/7i Cw., jv/. � G'2'/�� u Bus.Tel.No.: Tel.No *Per M.G.L.c. 147,s.57-61,security work quires Department of Public Safety"S"/ License: Alt.Lic.No..: Snv�6Y OWNER'S INSURANCE WAIVER: I aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ ?S— f