HomeMy WebLinkAboutBLDE-21-004693 '- Commonwealth of Official Use Only
, E` Massachusetts Permit No. BLDE-21-0046930
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:2/18/2021
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) 89 SWAN LAKE RD
Owner or Tenant MEANEY MARY R Telephone No.
Owner's Address 89 SWAN LAKE RD, WEST YARMOUTH, MA 02673
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check pp 'ate Box) (,�
Purpose of Building Utility Authorization No. ^.� 1r/ _
ie
Existing Service Amps Volts Overhead 0 Undgrd ❑ o. e� ///
New Service Amps Volts Overhead 0 Undgrd 0 . et kir
Number of Feeders and Ampacity / 4 '
d
Location and Nature of Proposed Electrical Work: Install additional lighting, receptacles, &smoke detectors.'ttpgrad�servile
4.r
Completion of the following table may be waived' I sr of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of rlf•1 :1
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above 0 In- ElNo.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
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 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: SAGAMORE ELECTRIC
Licensee: Stephen Davis Signature LIC.NO.: 22878
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 117 Old Plymouth Road, Sagamore Beach MA 02562 Alt.Tel.No.: 7743137154
*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: $75.00
VA-an kt atter 742,c/74
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Commonwealth o///lassac/ualellh Official Use Only
Permit No. c G 3
2epatment Ol 3ire Services
f = 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(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2/16/21
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) 89 Swan Lake Rd, West Yarmouth
Owner or Tenant Marcy Levington Telephone No. (617) 283-2860
Owner's Address 89 Swan Lake Rd, West Yarmouth
Is this permit in conjunction with a building permit? Yes ❑ No XI (Check Appropriate Box)
Purpose of Building Residence Utility Authorization No.
Existing Service 100 Amps 120/240 Volts Overhead ® Undgrd❑ No.of Meters 1
New Service Amps / Volts Overhead 0 Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Service Change, adding wafer lighting in bedrooms,
adding plugs to bedrooms, smokes to bedrooms.
Completion of the followingtable may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tof 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 Detection and
No.of Switches No.of Gas Burners 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❑ Municipalonnection 0 Other,
C
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: 2/10/21 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 IXC BOND 0 OTHER 0 (Specify:)
I certify,under the pains and penalties of pedury,that the information on this application is true and complete.
FIRM NAME: Sagamore Electric ,�/ /J LIC.NO.:22878-A
Licensee: Stephen Davis Signature 411 Jf �_ LIC.NO.: 53534-B
(If applicable,enter"exempt"in the license number line.) /y-"V� Bus.TeL No.• (774)313-7154
Address: 117 Old ymouth Rd 1B Sagamore Beach, MA 02562 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)0 owner ❑owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE: $ /50 CT