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Home My WebLink AboutBLDE-22-003222 �4 Commonwealth of Official Use Only ft. , \ Massachusetts Permit No. BLDE-22-003222 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked rRev.1/071 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:12/7/2021 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) 57 RIVER ST Owner or Tenant KELLEY KATHLEEN JOYCE Telephone No. Owner's Address KELLEY DONALD J,8 BROOKFIELD ROAD,WELLESLEY,MA 02181AI Is this permit in conjunction with a building permit? Yes 0 No 0 (Chec ,.rAir ) Purpose of Building Utility Authorization No. (vN'' Existing Service Amps Volts Overhead 0 Undgrd 0 e 40 New Service Amps Volts Overhead 0 Undgrd 0 A Number of Feeders and Ampacity 411,P I ' Location and Nature of Proposed Electrical Work: Replacement HVAC. O///��0 Completion of the following table' i dX4tdffa ctor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of `v(V/_��,�,oral Transformers C(JyVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighting grud. grad. 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 Ions 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 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* _ No.of Devices or Eauivalent No.of Water Key No.of No.of Ballasts Data Wiring: Heaters Signs 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:) S oe-380 5/7 I S 1 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Christopher R Swift Licensee: Christopher R Swift Signature LIC.NO.: 37071 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:8 PINE TER,E SANDWICH MA 025371432 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 40 /Z 1/2 X v Commonwealth o/ kamachuJetti Official Use Only —* _f Permit No. 22 - 3 272.... I, w t_ .2epartmen.t ol Jire Servicei I MIL". - : Occupancy and Fee Checked `i_ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK AU work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 C R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I i / 9 I City or Town of: (fryt '1 To the Inspector of Wires: By this application the undersigned Ives notice of his or her intention to perform the electrical work described below. Location (Street & Number) - Pi's,(-ee- c-V-40-6.. 4 Owner or Tenant aii Telephone No. le 1 ' 4-10 --- 10 35 Owner's Address 51- V, S-hc% Is this permit in conjunction with a building permit? ties n No (Check Appropriate Box) Purpose of Building -D(do ( Utility Authorization o. Existing Service AtZ Amps 13O / P(Volts Overhead ❑ Undgrd No. of Meters I New Service Amps / Volts Overhead ❑ Undgrd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: c ottxuloreA_ coaii&A.A.ff- 'Ai c_ C k • rtP(co iLtrILLictt Fur LC Completion 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. n grnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones of No. of Switches No. of Gas Burners I No. Inn and Initiating Devices No. of Ranges No. of Air Cond. Total No. of Alerting Devices g Tons No. of�� rite Disposers Total HeatPump Number Tons KW No. of Self-Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local (—] Municipal Connection Other No. of I) - crs 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 dromassa a Bathtubs No. of Motors 'Total HP Telecommunications Wiring: No. H Y g No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of yeitrical Work: e F0 ' ' (When required by municipal policy.) Work to Start: i ?Ni 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 cover a 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 penal 'es of pf 5iury, that the information onthis application is true and complete. FIRM NAME: I I" '� 1,IC. NO.: 3 'j) ' C Licensee: C1livi S Signature tIC. NO.: (If applicable, enter "exempt" rn the license number line.) .,, Bus. Tel. No.: JAL' ' 30V - 5'4- Address: Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department 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 PERMIT FEE: $ Signature Telephone No.