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Home My WebLink AboutBLDE-23-004181 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-004181 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:1/27/2023 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) —ME HEATHERWOOD Owner or Tenant Heatherwood Building 2000 Telephone No. Owner's Address HEATHERWOOD,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 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: R&R Roof top HVAC for 2000 building. 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 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine 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 Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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:) q8 3 ((7- 8 E E5 S I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: KELLY, MCKENNA AND DAVID ELECTRICAL CONTRACTOSR, INC Licensee: Connor K Tilton Signature LIC.NO.: 22722 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 5083178885 Address:398 Court Street Unit 3R, Plymouth MA 02360 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $80.00 zd z�3/ 3 Application Number: C.I.D.# //77 ////// 171 I Official Use Onlyof ,CJ t=_ ''=p, e77�� cc77 Permit No. C��"C('' Ce1=`' 2)eparlmenl O.._ .PP Servicee �(� _ l Occupancy and Fee Checked •w =eT I_ - BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 (leave blank) 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),,I Date: ,�G.Y\ure,- 9 20 Z City or Town of: �- �e�YY Tn the inspector of 'es: By this application the undersigned gives notice o his or her intention to perform the electrical work described below. Location(Street&Number)._____A� l c aT`�b6 v=�l\ Owner or Tenant l'.Q e ojs_,y t,,M]001 Telephone No. _$8 8.5 Owner's Address Is this permit in conjuntion with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Buildings 5 VCR-xYttS G 1 Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters C Number of feeders and Ampacity 0 Location and Nature of Proposed Electrical Work: 1��)cr-r f'�L �IS cc\r1v�c'�-(Y,,`�y y -11 J (ICYOo� -o� vtnk i� \v tl �;. 2.1100 Completion of the•,`ollowin 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 dNo.of Luminaires Swimming Pool grnd a grnd. Battery Units Lighting No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of Detection and No.of Switches No.of Gas Burners No.Initiating Devices Tot i No.of Ranges No.of Air Cond. Tons No.of Alerting Devices y No.of Waste Disposers Hot Pump Number,,._Tons,...,..,KW No.of Self-Contained P Totals: "''" "'-"'"""Detection/Alerting Devices _ No.of Dishwashers Space/Area Heating KW Local❑Mu Connicipnectialon Other No.of Dryers Heating Appliances KW Security Systems:* al No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring Heaters Signs Ballasts No.of Devices or equivalent - No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: 7- Y g No.of Devices or Equivalent Ji 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: 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❑ 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: -----1`t\rs y\ F GCYIL rl( - LIC,NO.: as laa-A Licensee: C_ \r\tw- —\--A V\ Signature C 4�--,TA-- LIC.NO,: (If applicable,enter"exempt"in the license nu rber line.) Bus.Tel.No.: 5 07i-311-B y g 5 Address: WI% C c,.)Y* ° �ni' mau-\1 o. ()amid 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 nor have the liability insurance coverage normally required by law.By 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:$ • 4 "' L. i ; . - .' , -.- . . . .. .. , _ a• ,! -die, - y: � -�� f' Rs. '';�`i� �; .4"�,}'.� +�� i•+. i ';y4�s 4-_T ; �y'�, ;� '� � p. ,�,. 1 0 Y ,'�cgs' " 9E ;.. ., -'1, e �" .. -r:_ r . '' .r {a :-�=at ,1i- .' :`k' • t ! Y. ._' ''At.'1'- ' t .. E l'ittr ! p t t'�i - , .. Y , `;. -'v`t-� �: _ `, "v e; ;•.3. .i`'.1`k C! �' , +� °" i III # ; + t, .� a • G_.Af.. •f�•1"' ' to vi.- s. z- 415" , t. a'i a ! e ,'q;.. <PP: - ,i:::1' 'i. ia,: .1f ,, hi#A 1'411:d.$ K .d ss,,i f !:.' 1 f y�•�, 9%. A'. 1 t c. Z$y. 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