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Home My WebLink AboutBLDE-21-005438 a Commonwealth of Official Use Only �E;,_` Massachusetts Permit No. BLDE-21-005438 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:3/22/2021 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) 28 PHYLLIS DR Owner or Tenant Mike Rockwell Telephone No. Owner's Address 28 PHYLLIS DR, SOUTH YARMOUTH, MA 02664-1680 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: Install bathroom receptacle&light in shower. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 1 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- CINo.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 Initiatine 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 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 ❑ 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: Licensee: Nicholas McEloy Signature LIC.NO.: 22642 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:31 Captain Carleton Road,Cotuit Ma 02635 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. PER x�" u 3(zP�(ZI (� al it r7\hrv0(z, * ��!! �j /! Official Use Only Commonwealth o`///assacKt�et J _ 1 i 2� cry cc77 Permit No, sJ n '., 2eparimenl el.tlro Services al Occupancy and Fee Checked 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(ME ,527 C R 12,00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /5 2-I City or Town of: ((�' r Ill()tti6 To the Inspec or of ires: By this application the undersigned Ives notice of his or or intent'on to perform the electrical work described below. Location(Street&Number) c2 ' Owner or Tenant —.ad 'Q o F Telephone No. Sot. 774•d 7602. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building - Utility Authorisation No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity j (1_ atioa nd Nature of Pr .posed Electrical Work: 1v�S c Ak C[& (i c�l.e� V lleC(•j. A /�� T < c ' Gl r f T in w GI!�f-J ric r i '1(-t 1 "'L 4'L tPfollowingtable rrf�a�be waived by the Inspector of Wires. Completion gL the No.of Total No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Transformers KVA r. No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In. 'go.of Willowy sighting No.of Luminaires Swimming pool grad. ❑ and. ❑ Bftttory Units ,.,,.,1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating DevIIes roil No.of Ranges TWO TWO No.of Air Cond. No.of Alerting Devices 'Neat Pew onel No.of Waste Disposers Totals;IrTunnbor„Ton�..,.....KhD....,.moo. ettoa ter No.of Dishwashers Space/Area Heating KW Local 0 , , : ,,,p 0 Other Heating Appliances KW Security mst No.of Dryers No.of or Equivalent No.of Water No.of---- Igo.of Data Wiring• Heaters KW Sys Ballasts Nil.OPIpleett fir Utilvtigltent n No.Hydromassage Bathtubs No,of Motors Total HP TeleNo of Devices oaqns uiv lent OTHER: Attach additional detail(I desired,or as required by the Inspector of Wires. Estimated Value of le ical Work: /lob' Oa (When required by municipal policy.) Work to Start: 3 �Q',Z-1 Inspections to be requested In accordance with MEC Rule 10,and upon completion. INSURANCE C V RAGE: 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 al BOND 0 OTHER 0 (Specltj+:) I cerf(Jy,under the pains and penalties of petjary.that the l�famsation on this application is tree and complete. FIRMNAME: Cane Cod Electricgl LIC.NO.: 22642-A c Licensee: N i c k M E I to y Signature LIC,NO.: (If applicable,enter"exempt"In the license number line.) Bus,Tot.No.t 19j-566.4489 Address:P.O. Box 1594 jvlgrstons Kills MA Q2648 Aft.Tel.No.. *Per M.O.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. 1 am the(check one)❑owner Qowner's agent. Owner/Agent I PERMIT FEE: $ 50-19 I Signature Telephone No. Email: Offtce@capecodelectrician.com