The URL can be used to link to this page

Home My WebLink AboutBLDE-22-004647 Commonwealth of Official Use Only t-. , Massachusetts Permit No. BLDE-22-004647 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:2/22/2022 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) 21 JOHN HALLS CARTPATH VI Owner or Tenant GILMORE LUKE A Telephone No. Owner's Address GILMORE CAROLINE B,21 JOHN HALLS CARTPATH VILLAGE,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 ❑ 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: Wiring for EV charging station. 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons 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 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 0 owner's agent. Owner/Agent Signature Telephone Telephone No. PERMIT FEE: $50.00 'k`.1 ..*-1 u 1/4) t ) ) Cf_De k uit_JZ ki AQC,1_,C9j____5e- Commonwealth o/r/laaaachu sei`to Official Use Only T Permit No.E- -q 47 2epat enf o }ire&wren # ' BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked �`•t_ �' [Rev. 1/07] (leave blank) qa { APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ,��I All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 27 CM 2.00 I (PLEASE PRINT IN INK OR TY INFORMATION) Date: „2 /el ?d oZ J City or Town of: C'U 1 q To the Inspec r of Wires: By this application the undersign gi es notice of his or her tention to perform the electrical w escpbed below. 3 Location(Street&Nnmber) J D k,t/ l ( C&c(4�.�J r9- / r oo-)--- Owner or Tenant , J c t /i'.,o v V Telephone No. ¶( p 7 iq 76/ C — Owner's Address Sty<"-A c5. i Is this permit in conjunction with a building permit? Yes 0 No (Check Appropriate Box) Purpose of Building Utility Authorization No. Q24 Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Und grd❑ No.of Meters Number of Feeders and Ampacity / Location and Nature of Proposed Electrical Work: (.lJ 1 VI , a c„ --1.-- 1 e� S f� �� c4 ekr; r i A/ to/`j'IA.��-� �// Completion of the folknvinartable may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fans T ra Tr of KVAnsformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmiu Pool Above In- No.of Emergency',wittingg and. Li grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches Na.of Gas Burners No.of Detection and Initiating Devices Total No.of Ranges No of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons K'W No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Munenicipaln 0 Other No.of Dryers Heating Appliances KW S�N�f SCyon Devices Stems:* Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Sivas Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications WE��rtng No.of Devices or Equivalent OTHER: Attach additional detail(fdesired,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. CHECK ONE: INSURANCE Z BOND 0 OTHER 0 (Specify:) I certify,under the r{s and o ury,t the information cm this apicatron is true and complete. / FIRM NAME: t-f a � Q.�'�f`1 C1 C,�) t C C. LIC.NO.:complete.,) Licensee: CO t l tA Signature( Q( Q, ,kT .L. LIC.NO.;5J 3 7//: (If applicable,enter"exempt" jThe license er line.nwnb , , �P , ��us.Tel.No.; _ Address: (,�{ , /E�� '17 it.TeL No.: 8 n- ' 't7 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie_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)El owner ❑owner's agent. Owner/Agent et.,Signature Telephone No. PERMIT FEE:$ 5