HomeMy WebLinkAboutBLDE-21-004848 AA.
Commonwealth of Official Use Only
E Massachusetts
Permit No. BLDE-21-004848
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:2/26/2021
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pertorm the electncal work described below.
Location(Street&Number) 48 MS CAMP ST
Owner or Tenant CONROY SCOTT P Telephone No.
Owner's Address CONROY JUNE L, 50 CAMP ST,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 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install recessed lights in livingroom.
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 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/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local ❑ 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 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.
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:
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. PERMIT FEE: $50.00
6)11,-4 / ?/2 (
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Pennk No. -1464n.
/�' Oooup y dPeeChooked �,�,.
,d BOARD OP FIRE PREVENTION REGULATIONS rRev.1o7�
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
An work to be porfbrmed in*condom with the Ma+aaolrueetts Fiorerlal Code 527 12.00
(PLEASE PRINT IN INK OR TYPE A INFORMATION) Dote: aZ 02/
City or Town oft U ! To lb.I star qj Ira:
By this appiartkn the andorsiynod sive of his or her I . . .on to porlbtm , o marina work described below.
Location(Street a Number) i ,II / .
Owner or Took_ . i. t.kphaaro No. 5--er 61570• . C
Owner's Address
lar this permit Is assisus$Ior with a bwilding permit/ Yoe * No 4 (Choat App opMnts Solt)
Purpose of Srdkliap Utility Aetkorisallon No.
t anks*ernes Asps / Volk Overhand 0 Vadprd 0 No.of Meters
Natiliaba Amps ( Volts O erirand 0 Uad$$0 No.of Meters
Phobos of?odors sod Ampecily
Looatioa nod Nara of Proposed Iliostrkal Wotlu Teez i' 's ' $'!r"!Yl�
•I I :1?( I b w/ j
i
No.of Passesod lAtiolosiro No.of CliAlop.(Paddl)hot t, , , it/.
No.of Louisan No.of Kat Tubs Outootora A
No.of Loeaisulnes Owl's**Pool ;,, Q Jiro, 0 ,, •i
No.of lleelptook Osilets No,of ON Bonin PM1 ALUMS Na of Lass
No.of bawls** No.of Om Swoon 4:64-.41iti,e,Y;
No,of Koos Na of Air Cent. No,of Doles
ai k a" . ,+ � 'W1Na,of Watts Disposes i .,,
No.of Dwhwa lkam epo se/Ana Iloatios KW l,,p, ver .,,,,. ... . ID Other
4:..
Na of Dryers � � KW .�'4k v . . ,.,
Mler'e KVVi „
Na,Hydrometer Notittoba No.of Moore Tota Kt ;'yf°"t, . '
mum
Estimated Value of 1 Wank; // (When nqukod by munkipsl policy.)
Work to Nun; il Z/ Inepootiono to be resoluta in aocoedrtnco with MBC Sulo 10,and upon completion,
IN$UURANCI ,s,, bit Unless waived by the owner,no permit kr the perlbrmanou of dimities,work m 'boo unless
the Rousse provide proof of liability Inswarco ktolutlino"completed operation"over*or Rs obeisant!solvates. The
undsrsteprod oertitUe that ouch aavenyps le In kroe,and has obibitud proof afore to the permit issuing of Poe.
CHECK ON*i INSUKANCE CSD SONO Ca OTHER is (ope itti)
i two,retrdv Otto famine W - i i gl',pa.*ss ,het►A*kilwomaos on pile alrplkolliawt 1r Nor ores/mg**.
FIRMNAM'S, , . L1C.NO.t 2,1sa2,,s
W,ansseor tiiprahre+a ''�• SAC.NO.t
(j/ aurr kww fnr Oise.Tel,No.alaNIE
Address • . , . . ' • Alt.'fel.Nat
''Per hi.0.1..o. 47,e ' , - : ... ' . "-r Safety. ,,;►,Llano Lis No. ..
OWNER'S INSVJBANCB WAYSt I am swat.the the kiosnaestdoss Nat kayo the liability �.., • •, �, woolly
rgri �b ,It +'. Sy my dint*"bolow,1 busby wslvo this requirement 1 am the(. ,._ +a •.,,;Mitt
y�..,
hraore Telephoto No. . ! *1 $ 5(. '/
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Email: OMceQpeapstodelectrklcn.com
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