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Home My WebLink AboutBLDE-19-002245 ISA of Official Use Only �)I'E''!ti Massachusetts Permit No. BLDE-19-002245 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.I/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:10/16/2018 City or Town of: YARMOUTH To the Ins ector of Wires: By this application the undersigned gives notice of his or her intention to perform the electric w descri d low. Location(Street&Number) 91 MASSACHUSETTS AVE LI, Owner or Tenant TYE DANIEL M Telephone No. . Owner's Address 91 MASSACHUSETTS AVE,WEST YARMOUTH,MA 02673 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install exterior receptacle. 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- o No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 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 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 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 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 derail 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: NICHOLAS MCELROY Licensee: NICHOLAS MCELROY Signature LIC.NO.: 53797 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:8 Blackthorn Path, Forestdale MA undefined 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 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 oil S Id12Jd'B ze— • �_ . t�onmoawaarth of lrlaaaachoatie ]O c' I Usc Only r ryry� c7 f7 Permit No. 4, - 2��' JJaParimsnt of tiro Serviced va Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] (leave blank) ii APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK d All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 Ar (PLEASE PRINT IN INK OR TYPE ALL IiVFORM4TIOI9 Date: len i/l/ City or Town of': LAf nik-. To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. J Location(Street&Number) 9 I Is szo.&u dI-S flVe-- T Owner or Tenant 'o.4 HI l It Telephone No.501-33I -05T b' lir Owner's Address 56-v•-e— • hIs this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) rr, Purpose of Building Utility Authorization No. J zExisting Service_ Amps / Volts Overhead❑ Undgrd❑ No.of Meters S' New Service _ Amps I Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: A a,,, Quits c1t :mild ori, On-)f. Sr).V Completion of the followingjable meg be waived by the Inspector of Wires, Lb No.of Recessed Luminaires No.of Ceil:Snsp.(Paddle)Fans Transformers EVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above ❑ In- ElNo.of Emergency Lighting grad. grad. Battery Units 0 8 ' No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones Iv No.of Switches No.of Gas Burners No.of Detection and ttt///JJJ `• Initiating Devices 1 i) No.of Ranges No.of Air Cond. Total No.of Alting Devices -Contained No.of Waste Disposers Heat Pump Number,ITons KW ! 'No.Detection/Alertingf Devices i�Nd t iof Dishwashers Space/Area Heating fKW Local 0 C nnection ❑ Other 111tb i:No of Ders Heating Appliances KW Security Systems:* Ft.tri No.of Devices or Equivalent r v cw ± of Water No.of No.of Data Wiring: - co i j d ; Beaten Ili Signs Ballasts No.of Devices or Equivalent �rr�,{��j--' !dYq Hydromassage Bathtubs No.of Motors Total HP Telecommunications f Devices oEquivalent V LU e--1 f4OTHER: "' Attach additional detail ifdesired,or as required by the Inspector of Wires. I lEstimated Value of Electrical Work: (When required by municipal policy.) Work to Start: to//6w/I 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 covyrage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 01 BOND ❑ OTHER ❑ (Specify:) I cernfy,under the pains and penalties of perjury,that the information on this application is true and complete. ' FIRM NAME: // LIC.NO.: 537973 Licensee: Nltk Mtflol Signature,/'' LIC.NO.: (If applicable,enter"exempt"in th license number line.) Bus.Tel.No:ria ii-S6 Address: IIS 3&t4, 61,,1. Mvri ,Ai AR/(/ 6acu er AIL Tel.No.: Y4 FY *Per M.G.L.c. 147,s.57.61,security work requires Department of Public Safety"5"License: Lie.No. OWNER'S INSURANCE WAIVER: 1 ant 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)0 owner ❑owner's agent. Owner/Agent PERMIT FEE:$ 5 DH Signature Telephone No.