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Home My WebLink AboutBLDE-22-000735 oo Commonwealth of Official Use Only El—,1 ; Massachusetts Permit No. BLDE-22-000735 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:8/9/2021 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) 411XFHEATHERWOOD Owner or Tenant Heatherwood at Kingsway Telephone No. Owner's Address YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A�riate Box) Purpose of Building Utility Authorization No. // Existing Service Amps Volts Overhead 0 Undgrd 0 o.o New Service Amps Volts Overhead 0 Undgrd 0 .o r Z Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Rewire second floor bathroom 85Completion of the following table may be/4;1047,4)? e for of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of 1 Transformers No.of Luminaire Outlets No.of Hot Tubs Generators A No.of Luminaires Swimming Pool Above o In- ElNo.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 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 ❑ 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 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: 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) 0 owner ❑ owner's agent. -' \, Owner/Agent Signature Telephone No. RMIT FEE: $80.00 8( ' r, - _ DD // $ , b Commonwealth.o/Maseachuaetfa Official Use Only =_ —AA/ c� n Permit No.-22'° 7 99 I =ra c7 c ._ _1 2epartment oy .}ire Services °�=i__ Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07 .� j (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) Date: I Q La City or Town of: Y c rYy,OvAL 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) 1 ZT \p CA (\ .co c Owner or Tenant t`6 cA-AL f L c)A c, L<1 . W(` 2'—, { Telephone No.9 I % 5 Owner's Address On ,-- },.,f Woy cQ JC1 / cLrm6 LAk Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building I0��C A A('Q Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead n Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ram`.. \� _ j '3,rC c\Dor err,C - awl ��& ' , r _ 5�1 s 5tnic_ mpletion of the following table may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf 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 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 Tons No.of AlertingDevices 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 Data Wiring: Heaters Signs Ballasts 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�V (N� Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVER: 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: --1-1 lkpr F 12Cr �. _Lfl(.. LIC.NO.: d a 7a a,l Licensee: 0 ,N'1110r- ri( Signature C --- s LIC.NO.: (If applicable,enter "exempt"in the license,number I've.) Bus.Tel.No.:J0$-3/%-a5 Address: $ (r,�Lir t k., f�� n-j c�J.`�� J C.` Alt.Tel.No.: *Per M.G.L.c. 147, s. 57-61,security work requires Depart1 nt of 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)❑ owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ _� �� _ / � �`' ° ` ` ' � ' � � �� ' -`| �� ^� , _ ' z ' . m ^� ^ ' __' _ �---_--_- _ __' ___ _ -- ' ^ �� -'_ _ - _ __ '__-____-_ ___' ____ �.',�� -'` ` ' __ . _ _ __ ___ _ ' ____ _- -_--� - .�