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Home My WebLink AboutBLDE-22-002953 \1/ Commonwealth of Official Use Only 1 Massachusetts Permit No. BLDE-22-002953 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:11/21/2021 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) 90 SEAVIEW AVE UNIT 3C Owner or Tenant WARD ANN S Telephone No. Owner's Address 137 RIMMON AVE, CHICOPEE, MA 01013 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: Wiring of split NC system&install surge protector. 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 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 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 ❑ 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: WALTER W KELLY Licensee: Walter W Kelly Signature LIC.NO.: 21302 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 7 MONROE LN,WEST YARMOUTH MA 026732731 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: $50.00 "v - (A)i1 (q/( t.Jl,2st/ (&aci -t r t Cf/o4, -* J _ Commonmea(h of maddad.welid Official Use Only ` r-` cy �7 /`J Permit No. �Z2-2ct 53 U l.a 1/eparlitunl 0/..tin&NiCM I Occupancy and Fee Checked ,, ) BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK .-3 All work to be performed in accordance with the Massachusetts Electrical Code(MEC),52l CM/a 12.00 .I (PLEASE PRINT IN INK OR TYP nI/NFORMATION) Date: (1�j f. ` _/ City or Town of: y '1 In ( To the Inspector df Wites: By this application the undersign gr notice of his or her mtentiont./ to perform the electrical work^rk described below. Location(Street&Number) b _5-pen)///W v^//T 3 Owner or Tenant ANA/ (A(t49r1 to Telephone No. fr.F-y 72/// 7 Owner's Address /37 vial--0,, j40._Q Chi C fHf cl//I/3 Is this permit in conjunction with a building permit? Yes ❑ No k.r (Check Appropriate Box) Purpose of Building Utility Authorization No. �� Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters -� New Service Amps / Volts Overhead❑ Uudgrd❑ No.of Meters ONumber of Feeders and Ampacity 3 Locatio and Nature of Proposed Electrical Work: I //�//j/� (+) z� /f/�/ .T 7)16 S 5/-P f 2�c Yl �S it .e�r or dt7 i L ^ Completi f the I/lowing table may be waived by the inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of TotalVA Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming pal Above ❑ In- ❑ No.of Emergency Lighting grad grad. 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 an d Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 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 0 MomunicipaleMion 0 Other C No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.ofICW Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent _ No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: Na 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: 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. HECK ONE: INSURANCE jg BOND 0 OTHER 0(Specify:) certify,under t,h,e'�°i ,a^nd�enahie�of ury,t the information an this applc-aallon is true and complete.7 /, ❑�-- rz RMNAME:1.ktt t� W ¢l QCr\'I 1C\G� 1 CIC, LIC.NO.: I�L�� 7 ( o icensee: t /(1 Signature(QO j Q(4 11/,L.0 LIC.NO.:S 13cf//. N �2 fapplicable,enter'esempt"�7Fe license number line. vv s.TeL No: — , oo ddress: 7 to m ti]rA n\.._0 G (� (,U, �/yy(� t f Alt.Tel.No.:50K— ( ---G417 Ill ' P Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. c _ WNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally O ;-) r uired by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's a ent. er/A ent tr.) m gnature Telephone No. PERMIT FEE:$