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Home My WebLink AboutBLDE-23-005346 0"' Commonwealth of Official Use Only pee' Massachusetts Permit No. BLDE-23-005346 'a-r' 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:3/29/2023 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) 30 MOSS RD Owner or Tenant FINNERTY PAULETTE J (EST OF) Telephone No. Owner's Address PAULETTE J FINNERTY REV TRUST, 110 BLACK OAK RD,WESTON, MA 02493 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: First floor remodel. 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 SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting No.of Luminaires grnd. grnd. 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 Initiatine Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alertine Devices Local 0 Municipal 0 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 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: FRANCIS WELLES LIC.NO.: 53794 Licensee: FRANCIS WELLES Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.N o. Address:456 Grand Ave,Apt 5,Falmouth MA 025403476 o.: *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 ❑ owner's agent. Owner/Agent Signature Telephone No. PER IT FEE: $75.00 e.00e6te Lt( tteb, tJ�k ik OY 7(21/ 3Kt. �c N (� ccs.,colc.(s„) 61 r y(�3 w ,'I! 6inL/ I /Ai RECEIVED �offieiai use only iWi '. MAR 2 9 202 ' '" nlad'acl °� Permit No.�..Z�— t �:I tievieto ., �] (\`J a` 1 DING DEPARTMENT Occupancy and Pee Checked �'_._.- .- .: ,. •REVENTION REGULATIONS [Rev. 1/07] (leave blank) \ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK `V All work to be performed in accordance with the Massachusetts Electrical Code(M ),527 R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMAT7 ) Date: 3 - - , CityTownof: gpV](01 To the Inspector o Wires: By this application the undersigned gives notice of his or her mtend to perform or W �� the electrical work described below. Location(Street&Number) a5.15 Owner or Tenant di ayy L SiI ) Telephone Na. Owner's Address Is this permit in conjunction with a building ? Yes No El (Check Appropriate Box) V\ Purpose of Building s6SI -0-�i� Utility Authorization No. a: Existing Service Amps / Volts Overhead C Undgrd No.of Meters New Service Amps I Volts OverheadEl ❑ No.of Meters Number of Feeders and Ampacity j��l�f L �� Location and Nature of Proposed Electrical Work: -f- e ', 7 s. nsp yr Completion of the following,table may be waived by the Inspect'r of Wires. iiiNo.of T a 13 No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans s. Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVANo.of Emer enc Lighting SwimmingPool Above ❑ g y g g ▪ No.of Luminaires grnd. grad. Battery Units I ` No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones trio.of Detection and z- No.of Switches No.of Gas Burners Initiating Devices I r No.of Ranges No.of Air Cond. Total l ,No.of Alerting Devices Heat Pump Number Tons KW �No.of Self-Contained No.of Waste Disposers Totals:I I I Detection/Alerting Devices M No.of Dishwashers Space/Area Heating KW Local 0 Conuecunicihopal n 0 Other , Heatin AppliancesSecunty Systems:* No.of Dryers g KW No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: KW Heaters Signs Ballasts No.of Devices or Equivalent TelecommunicationsWiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: y��1 ) Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of 1 NV tit: , ) f/ (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE O E: 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 Ell BOND 0 OTHER ❑ (Specify:) 1 certify,under the pains and penalties of per} , `,' , station on this appiie- u Is true and complete. p FIRM NAME: ��44 2:: . _£ _:�� LIC.NO.: 5 '/%� i ir LIC.NO.: Licensee: Signatu � ��r�.�� (If gpplicabk,enter"exempt"In t�f Ike a num I' .) ill r/Bus.Tel.NO.: Address. 6/r.( S(Gl-/ rn ?'�/ eviz m 5J�Alt.TeL No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety" "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,I Owner/AgentI Signature Telephone No. PERMIT FEE:$