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Home My WebLink AboutBLDE-23-001287 Commonwealth of official Use Only .-or'iiiiiki Massachusetts Permit No. BLDE 23 001287 ....;.d 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:9/12/2022 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) 15 HAYWOOD AVE Owner or Tenant SMEDLEY KENT B Telephone No. Owner's Address SMEDLEY NEUCIMARI B, 15 HAYWOOD AVE, SOUTH YARMOUTH, MA 02664 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 ❑ 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: Bathroom renovations Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 1 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 2 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 1 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 Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 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 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 Licensee: Jarlath A Galvin Signature LIC.NO.: 10861 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 100 ACORN DR, OSTERVILLE MA 026551370 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 � C E I '� � D Wit( Co�P LSEP 0 9 202 :_:. Commonwealth. �/1/) / _.... _ 1- Ij l�ommontvaaCth o��//addathudattd Official Use Only 01 cc�� cc77 n 2 Z `7 BUILDING UEPARt »:: -CJslvartmanloi,}' J Permit No. — By 1IC; era arvicsd ' kr- BOARD OF FIRE PREVENTION REGULATIONS :, Occupancy and Fee Checked _ 01 [Rev. 1/07j leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO All work to be performed in accordance with the Massachusetts Electrical ode( EC),5?7 CMR 12.00 WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: v Date: Z2 By this application the undersigned giv snot M O or TH intention perfTorm th the I electrical,trical,work ctor Location(Street&Number) S. �� - described below. Owner or Tenant ` �k p;I(,C z Owner's Address Telephone No. Is this permit in conju etion with a building permit? yes NO El (Check Appropriate Box) Purpose of Building Of1.42 Existing Service_ Utility Authorization No. Amps ' Vol ___ ts Overhead❑ Und rd New_ S:Ce g ❑ No.of Meters Amps / Volts Overhead Number of Feeders and Ampacity ❑ Undgrd [] No.of Meters Location and Nature of Proposed Electrical Work: t.-N I coin' t 4r i, i{;. Completion o the ollowin_table m be waived b the Inspector o Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans '°•° ota No.of Luminaire Outlets Transformers KVA r-::ti 2 No.of Hot Tubs No.of Luminaires Generators KVA Swimming Pool ,rnd.e ❑ " '°.° mergency g mg No.of Receptacle Outlets I = "d ❑ Batte Units No.of OH Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 'o.0 l etection an. 1' No.of Ranges Initiatin Devices No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers 'eat 'ump `um er Totals: ons F' o.o e - onta ne, Detection/Alertin, Devices No.of Dishwashers Space/Area Heating KW Local •un clpa No.of Dryers Heating Appliances ecu Connection ❑ Other `o.o "ater KW ty ysteins: Heaters KW `o.o .° ° No.of Devices or E 1 uivalent Si ns Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Devices or E.uivalent No.of Motors Total HP a ecommun ca ons " rmg: OTHER: No.of Devices or E i uivalent Estimated Valu of E[ectril Work: Attach additional detail ifdesired,or as required by the Inspector of Wires. Work to Start• le tr -1 (When required by municipal policy.) A. Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO ERAGE: 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [BOND I certify,under rite • ins and pens! 's o ❑ OTHER 0 (Specify;) FIRM NAME:��• 1.0t'b*c f,,i4.1 ,that the tnfortnatien on this application is true and complete. Licensee: ,�:�i. �t�` rr o� 1.r- LIC.NO.: - Licensee: •}fit - (Ifanplicable,enter a • .t t 'tl�e hcerye nu 1.er line.) Sig lure . ;� s �� Address: $ '0 1 d4 b y— LIC.NO.: C] *Per M.G.L.c. 147,s.57-61,securitywor. ,�rics� i-2l fig' Bus.Tel.No.• $ 4 OWNER'S INSURANCE WAIVE : I am awarestha phare-trnen Licensee does t of Public not have the liability Alt. Tel.No.: OWNER'S by law. ByLic.No. Owner/Agent my signature below,I hereby waive this requirement. I am the(check one a ranee coverage normally Signature owner � owner's a.ettt. Telephone No. PERMIT FEE:$ 7 S c/C-IkJ2