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Home My WebLink AboutBLDE-22-003023 of Commonwealth of Official Use Only 1 Massachusetts Permit No. BLDE-22-003023 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:11/24/2021 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) 223 ROUTE 6A Owner or Tenant FITZGERALD SHEILA M TR Telephone No. Owner's Address SMF REALTY TRUST, 223 ROUTE 6-A,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 ley! Number of Feeders and Ampacity `(' � Location and Nature of Proposed Electrical Work: Two split A/C's f Completion of the following table may be waived 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 ;Initiatine Devices No.of Ranges No.of Air Cond. 2 Total No.of Alerting Devices Tons Heat Pump Number Tons KW ,No.of Self-Contained No.of Waste Disposers _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 Eauivalent 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 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjuty,that the information on this application is true and complete. FIRM NAME: Brian R Kilroy Licensee: Brian R Kilroy Signature LIC.NO.: 29376 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 66 SWIFT BROOK RD, S YARMOUTH MA 026644040 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: $80.00 RECEIVED NOV 2 2 2021 a ��al Maseae%sm.r� .. Official Use oral 22 i ''SING Ut PARTME(�7 �e77 Permit No. _f,�2—' Q?'J a. ). _— ______ �eparGweni o/Jin • �eruiced BOARD OF FIRE PREVENTION REGULATIONS [R v.Occupancy 07] (kaFce Checked 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 1 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ///7 Z/7( City or Town of: /t />7, el To the Inspector of Wires: - By this application the undersigned gives notice of his or her intention�to9 perform the electrical work described below. Location(Street&Number) AZ2 3 /1� <� Y 1q,P,,ys„i,--� e,,.,/ Owner or Tenant „QR,p.&.e Liz J S Telephone No. Owner's Address 5.4.4...4 Is this permit In conjunction"yl'abuilding permit? Yes ❑ No,t (Check Appropriate Box) ®i Purpose of Building(.2�.y1'i ,cif ,yW Utility Authorization No. tExisting Service LOG, Amps /2.'' I Ia�Volts Overhead CIUndgrd� No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity s e Location and Nature of Proposed Electrical Work: �y:N// Z i.01.4 I,i (kr j� _SW. ��c pysi .)..--"/f 1.2r.e_ Si2.e� 2E.,.t'-,4 Pnc t aic f.-,/ V1 Completion of the followin table may be waived by the inspector of Wires. W No.of Recessed Luminaires No.of Cell.-Sup.(Paddle)Fans To'of Total Transformers KVA CI No.of Luminaire Outlets No.of Hot Tubs Generators KVA a k No.of Luminaires Swimmiu Pool Above ❑ In- 0 No.of Emergency Lighting g 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 and Z. Initiating Devices I U No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste rs Heat Pump Number Tons JKW No.of Self Contained Dlspou Totals: _. Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 Co nnoectlon eciai ❑other No.of Dryers Heating Appliances KW Security Systems:. No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Devicesous Wiring: No.of or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Workr v,,,c'6 (When requited by municipal policy.) Work to Start: ///22/e/ 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 thsAains and penalties of perjury,that the Information on this application is true and complete. FIRM NAME: g'? ) /6.L LIC.NO.: L Z9 37k Licensee: at r"e/!l'idhe Signature �f� � LeL No.::f l y_;7 Y (lJapplicable,enter"exempt'! the license number line.) i Bus.TeL No.:F:u 3.75/- 'dGh Address: 2) fib it/ ')) r_� DI,--.5.f 1 ‘,44, /92 O Alt.Tel.No.: *Per M.G.L.c.147,s.57-61,securify 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. y signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature ,��A/na-,.(A Telephone No.�`' ' E` . PERMIT FEE:$