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Home My WebLink AboutBlde-20-000436 or O� Commonwealth of Official Use Only �� Massachusetts Permit No. BLDE-20-000436 r- 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:7/26/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice or his or her intention to pertorm the electrical work described below. Location(Street&Number) 23 GASLIGHT DR Owner or Tenant GLIVINSKI TAMMY A Telephone No. Owner's Address 23 GASLIGHT DR,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 Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for split NC&stove. 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 Initiatine Devices No.of Ranges 1 No.of Air Cond. 1 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine 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 Data Wiring: Heaters Siens 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: 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. �� f , I, '8 CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) (G(G ,!� 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 c w i- Aff L9eZ 453(fP((' ceS (z3(/? ,‘.1 ( Commonwealth o`Maddachudelld Official Use Only I # >ii� c�r Permit No. t '-co 4'3 co !; 2opartment on ire Serviced �-A � Occupancy and Fee Checked f3 .).9Y C -,, ---,A' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (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: 7 3/C City or Town of: A(rAAn,l\ 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)d�� GovS(,+4)h, an te___ Owner or Tenant 2` )tJ co - -- Telephone No. 6/7_ $VS fir;4 if Owner's Address QV-le Is this permit in conjunction with a building permit? Yes ❑ No El (Check Appropriate Box) Purpose of Building Utility Authorization No. ,�l Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters tp New Service Amps / Volts Overhead El Undgrd ❑ No.of Meters a Diu ber of Feeders and Ampacity o� I�i,ol tion and Nature of Proposed Electrical Work: �1I 2 ar�o mit i S; iit 1 A/r CUru¢ E o j'a-: I -r Gvtr cV I Q I . c Completion of the followingjable may be waived by the Inspector of Wires. Total LL p.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No. f Trano KVAsformers KVA 0 z. = ?N of Luminaire Outlets No.of Hot Tubs Generators KVA LU.i ' ' Above In- No.of Emergency Lighting -�'N of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units nIsf 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 Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ ConnectMunicipal ion El OtherNo.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.H dromassa a Bathtubs No.of Motors Total HP TelecommunicationsNofDevices or qu v y g No.of Devices 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: 7/9,,Sl 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Cape Cod Electrical LIC.NO.: 22642-A Licensee: Nick McElroy Signature l��/� LIC.NO.: C 3'79 7 (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: 508-566-4489 Address: 31 Captain Carleton's Rd, Cotuit, MA 02635 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)El owner El owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ Email: Nick@capecodelectrician.com