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Home My WebLink AboutBLDE-22-001780 Official Use Only Commonwealth of Massachusetts Permit No. BLDE-22-001780 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:9/28/2021 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) 122 WATER ST Owner or Tenant Michael Hagerty Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Chec Appropriate Box) Purpose of Building Utility Authorization No. c-z.,„„ge SO 6-(/t=7 ge 'd Existing Service Amps Volts Overhead 0 Undgrd 0 No. f Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Permit&inspection to clear out expired permit. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires 9 No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets 20 No.of Oil Burners FIRE ALARMS I No.of Zones No.of Detection and No.of Switches 6 No.of Gas Burners Initiatine Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump I Number I Tons I KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertint=-Devices ❑ Municipal 0 Other: No.of Dishwashers Space/Area Heating KW LocalConnection Security Systems:* No.of Dryers Heating Appliances KW 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. required Estimated Value of Electrical Work: (When 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: JARLATH A GALVIN LIC.NO.: 10861 Licensee: Jarlath A Galvin Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address: 100 ACORN DR, OSTERVILLE MA 026551370 *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 'PERMIT FEE: $50.00 I Signature Telephone No. dkTC4ILJ ACMCAS Po& iho/2 L.)0.34;4414,, WO z- 2. i"�8�'0 �- Commonwsatth of Mamacitudotto Official Use Only LJJ f ' • B, � c-� n Ja Permit No. 22---lr �lJs/vartmsnE o�Jirs rvu se 6 N r:, i) ; v Occupancy and Fee Checked '-• ' S,• BOARD OF FIRE PREVENTION REGULATIONS [Rev. (leave blank) 4 S , 0 a.. _ ' PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK LU All work to be perfonned in accordance with the Massachusetts Electrical (%IEC),52`CMR 12.00 4PL..._ ,EASE PRINT IN INK OR TYPE ALL INFORMATION) Date cP11 A d'� 2 i n City or Town of: YARMOUTH To • the Inspector of Wires: his application the undersigned gives notice of his or her intention to perform ilk 104TtsotomC electrical work described below. Location(Street& umber) l 22 0� �}'" ,` Owner or Tenant l t ,r,Q,, V ea Telephone No.'4 e% e41-Ziz Owner's Address Is this permit in conjunction with a building permit? Yes No 0 (Check Appropriate Box) Purpose of Building iApl►141.. Utility Authorization No. Existing Service 200 Amps 'AD/ \'1,0 Volts Overhead Uudgrd 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: C)lcj at" evf,, t. Completion of thefollowinktable may be waived by the In ector of Wires, Total W No.of Recessed Luminaires Tr KVA ns No.of Cell.-Susp.(Paddle)Fans T of aformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA 47 No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting 3 grnd. ❑irnd. ❑ Battery Units i No.of Receptacle Outlets zp No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and 1 6 Initiating Devices III No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Contained Totals: "" Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Loci 0 Co nicip nnection 0 Other Co 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 Equivalent Na 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: 000 (When required by municipal policy.) Work to Start: Ins tions 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 ❑ OTHER 0 (Specify:) I certify,under thins and pens s ojperjury,that the Information on this application is true and complete. FIRM NAME: �q Rke ttv _ LIC.NO.: O 6 Licensee: v ;I Signature M LIC.NO.: L 0 t b I (If applicable,enter"exempt"in he license number line.) Bus.Tel.No.' Address: Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department o 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's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$S O