HomeMy WebLinkAboutBLDE-22-005076 ECommonwealth of of07ficial6 Use Only0
Massachusetts Permit No. BLDE-22-005
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.l/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:3/14/2022
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) 126 WIMBLEDON DR
Owner or Tenant FOLEY RICHARD D Telephone No.
Owner's Address 7 FLAGG RD,ACTON, MA 01720-5611
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 generator&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 1 KVA 13
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 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 Ballasts Data Wiring:
Heaters Siens No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Eauivalent
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: SANDY I MCLARDY
Licensee: SANDY I MCLARDY Signature LIC.NO.: 51160
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:608 MAPLE AVE, EWING NJ 08618 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 my
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: $50.00
( / ie U-1 Vg
Commonwealth o`//lamac�etta Official Use Only
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cc�� c7 Permit No.
MAR. G �t 5 2)epartment o�`.tire Servicers
E i', Occupancy and Fee Checked
1 LBUILDING u ,.�-: ENT ARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPELL INFORMATION) Date: 3 --1 – 1
City or Town of: - G., 0,-,f,, To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to p orm the electrical work described below.
Location(Street&Number) 1 J J ;�,,,, lee)0 A ff.'
Owner or Tenant f . ?O e 1 Telephone No.1 78-Wr-03g I
Owner's Address c-').4 pi E. F co 8$fI i
Is this permit in conjunction with a building permit? Yes ❑ No p (Check Appropriate Box)
Purpose of Building Utility Authorization No. pQ j -1 i
Existing Service /fin Amps 1,2 0 /,gyp Volts Overhead 0 Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: 54 # / .-sK (....1j/4 0 t/.. 5 747 4,47
T-7,,,,,,
Completion of the followin&table may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.Transformersn
KVA
No.of Luminaire Outlets No.of Hot Tubs Generators ( KVA / 3
No.of Luminaires Swimming Pool Above ❑ In- 1-1 No.of J mergency 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 AlertingDevices
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 ��❑ 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 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: / 2--‘49° (When required by municipal policy.)
Work to Start: 3 // - , .) 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 coy-age is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE.6'i BOND ❑ OTHER 0 (Specify)
I certify,under the ains and penalties ofpe ury,that the information on this appli 'on is true and complete.
FIRM NAME: 4 n/? /'7 C L ✓ LIC.NO.: ..-.1( 4 d
, /Licensee: _. p,v161 1-1c. 1�.v 2„ Signature /,v, LIC.NO.:
(If applicable enter "e pt"in the sic `numb$r line.) j J`t'
Bus.Tel.No.: .2 i SsArS a
Address: :X 10 /frat9r.-1 I Qd 114.-w;., 4 IIA cI.26 rYS 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)❑owner 0 owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE: $ 50
CICS I3?