HomeMy WebLinkAboutBLDE-21-006522 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-21-006522
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:5/11/2021
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) 47 SKYLINE DR
Owner or Tenant LAINE ANDREW M Telephone No.
Owner's Address 47 SKYLINE DR, WEST YARMOUTH, MA 02673
Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters
New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Upgrade service&install transfer switch.
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 0 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
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 ❑ 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 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: MICHAEL J LEBLANC
Licensee: Michael J Leblanc Signature LIC.NO.: 17423
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 16 Westwind Cir, Osterville MA 026551375 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
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�I epartmani a ..fire_ eruicee
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/O7] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MliC),527 CMIt 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 5/7/2021
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) 47 Skyline Drive
Owner or Tenant Andrew Laine Telephone No. 774-212 08u
Owner's AddressIs this this permit in conjunction with a building permit? Yes n No V (Check Appropriate Box)
Purpose of Building Residential Utility Authorization No.
Existing Service 100 Amps 120/240 Volts Overhead Undgrd No.of Meters 1_
New Service 20Q_ Amps 120/240 Volts Overhead V Undgrd ❑ No.of Meters 1 _
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Service upgrade 100A to 200A —
includj)gg a transfer switch -- —
_ Completion of the/o1owin_table may he waived by the Inspector of Wires.
otal
No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of KVA
p Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires! Swimming Pool Above ❑Tn- ❑ No.of Emergency Light n---
grad. grnd. Batter Units _
No.of Receptacle Outlets No.of Oil Burners !FIRE ALARMS No.of Y.ones —I
'4o.o etection an
No.of Switches No.of Gas Burners Initiatin!Devices
Tota
No.of Ranges Tons —
No.of Air Cond. No.of Alerting Devices I
c'>FT at untp , "a' ons ; `o.o ,e - ontaine1
No.of Waste Disposers
r 'totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ ?'iTiinicipalCyonnection C1 Other
No.of Dryers Heating Appliances KW ecurity stems:*
No.of Devices or Equivalent
No.of Water KW No.of— No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or E r uivalent
No.H dromassa a Bathtubs No.of Motors 'Total HP e Neco of Deviatso or �',r agl
y h No.of Devices E r uivalent
OTHER:
Attach additional detail if desired,or as required ht'the inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: 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 us substantial equivalent. The
undersigned certifies that such coverage is in force,and has exhibited proof of saute to the permit issuing office.
CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:)
/certi/y,under the pains and penalties of pedury,that the information thi plication is true and complete.
FIRM NAME: Solar Rising LLC i LiC.NO.: 821 .A1
Licensee: Michael LeBlanc Signature LIC.NO.: 17423 A
Of applicable.enter -exempt-in the license number lint:.) �'0� -- Bus.Tel. No.' __ _74L-U84
Address: 759 Falmouth Rd Suite 8 Mashpee MA 02649 Alt.Tel.No.: 774 27(-4125
*Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lie. No.
OWNER'S INSURANCE WAIVER: I 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 ant the(check one)❑owner ❑owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $