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HomeMy WebLinkAboutBLDE-22-002306 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-002306 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:10/22/2021 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) 40 WHIFFLETREE RD Owner or Tenant FREEBERG LAUREL D Telephone No. Owner's Address FREEBERG REIN C,40 WHIFFLETREE RD,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 range receptacle. 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- 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 Initiatine Devices No.of Ranges 1 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 ❑ 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 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 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 Al.onunonwsafth of madeacLeelle Official Use Only ,.. * + 'r c� �a Permit No. Z C a+ 2epariaseni of.ire.Jervkee ,* Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) WO APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 7 CM 12,00 (PLEASE PRINT IN INK OR TYPE ALL I FORMATION) Date: /6 t -Z( City or Town of: a fe wt 0 V44 To the Inspector of Wl es: By this application the undersigned gives noti a of is rher intention to perform the electrical work described below. Location(Street&Number) III** IA- Location L.E 6 /QC-I- Owner or Tenant /au re l .'ri'e her? Telephone No.6/7. 57-1? 17/01 Owner's Address is this permit in conjunction with a building permit? Yes 0 No VS (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❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed rlectrkal Work: 0{2 -1 c.(,k_ Nf,W I{Ll AWiQa Completion of thefollowingtable mal be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-Suap.(Paddle)Fans No.of KVA Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above ❑ in- ❑ ivo.of tans0rgeney Lighting grad. arnd. 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 g Torts Total No.of AlertingDevices Heat Pump NumGer Tons KW INo.of Self-Contained No.of Waste Disposers Totals: _ Detection/.Ai- +.,a Devices No.of Dishwashers Space/Area Heating KW Local 0 Co uninnectl pal4n 0 Other No.of DryersHeating Appliances KW -Security Systems:* No.of Devices or Equlivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP TelecommunicationsN * cer in Y g Na.of Devices or Equlv�ltt OTHER: Attach additional detail((desired,or as required by the Inspector of Wires, Estimated Value of E ectrical Work: / 3 00 ' (When required by municipal policy.) Work to Start: /© ' inspections to be requested in accordance with MEC Rule 10,and upon completion, INSURANCE CO RA : nless 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 BD BOND ❑ OTHER 0 (Specify:) I earth',under the pains and penalties o f perjury,that the information on this application is true and cotnpk FIRM NAME: Cane Cod Electrical LIC.NO.: 22t;42.A Licensee: Nick M c E tco v Signature ---- LIC.NO.:670 Al(Business) (if applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 508-566-4489 Address: 381 Old Falmouth Rd Ste 32 Marstons Mills,MA 02648 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-6 t,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 0 owner's,aent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ a-0 •c) Email: Office@capecodelectrician.com