HomeMy WebLinkAboutBLDE-22-000567 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-22-000567
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:8/1/2021
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) 67 CAPT WRIGHT RD
Owner or Tenant LEMIRE GEORGE R LIFE EST Telephone No.
Owner's Address LEMIRE ELEANOR M LIFE EST, 67 CAPTAIN WRIGHT RD, SOUTH YARMOUTH, M ` 664-2859
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check . i $ ,r"• e Box)
Purpose of Building Utility Authorization No , a, II�
Existing Service Amps Volts Overhead 0 Undgrd 0 '' i o SU't?'•raj [�
New Service Amps Volts Overhead ❑ Undgrd 0 o. . 4 w
Number of Feeders and Ampacity 4 4,,,
Location and Nature of Proposed Electrical Work: Install generator&transfer switch. ` - `,
Completion of the following table may be wail, , y �ector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of a tal
Transformers VA
No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA 18
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 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 ❑ 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: $50.00
Viz/ -reexCA i,u,-_ t."J sr t 4 Aci S-.)53fri,v6 Cc7,•,W it /e.4,?rG "f-r 6e-A./.
iik, f OM MP 7 /I N
�/ Permit No -'d 7
w Occu r=;ked
! BOARD OP TIRE PREVENTION REGULATION$ lbw, vosn
APPUCATION FOR PERMIT TO PERFORM EL, CTR1CAL WORK
All work to be p►rf rmed In acortionco with Na Manualtusta Khabia&Code 3t9 CMR 12.00
(PL&4SB PRINT IN INK OA TYPE A 1 NFORMATION) I)stet Al.. i 1,,,,,,�
City or Town of - cf Pk L* To the I ctor,f Wino
By this spoliationdm undenipned gives oo of hi or her Intendon to perform the eotricel,voik described below,
Location Mrs*dk Number) lf`1 % / .
Owner or Toast ,.0-13 ryt.t✓` . t'-C., Telephoto Nc. 5 DP 3' °•F 7s—
Owser's Wrote .
le this permit in oorkbraedon with a WW1- es wash'? Yoe En No 0 (Chock Appropriate Son)
Purport.ot%Ming Utility Aelborleattoa No.
icrctetied llervta
Amp* / Volts Overhead 0 Uedgrd 0 No.of Meters
it k - Amps / Volta Ovorhood 0 Vatpprd[3 No,of Meters
Number of Footairs sad Aspseity
1 sap Natant of Illesolcol Wort: l GO
u.,f 1 . (7 14111 ‘A-hofe nahe - wa
No.of Sortahred Lossittslres No.ofCe1 ( )Amu 1.4
No.of Litailaidr.Outlet, No of not Tabs t)tmorakort KVA
No.of Lanwrisaitw rrttetr Pool A11ad"1►# d- te#.blp° j x >
No.of meoepts.M Oadots Na of Oil Scam PIO ALARMS No.of Loos
No.of Switches No.of Ose Haraem -err m" „.,,
No.of Snags No.of Mr Coat No.of Dicke
No.of Witte mere rp.li LI ! r 0061 t'. ,,
Space/Arc NOON KW Leal a ° ,. .' C thwr
Na of DMlrr,eub�nr S��"'^' '
r w.,r�. a i
A►ppfaeooe KW4,1,
No.of Dryers � Y ,r : ` •, ��
ergs w
No.Kydr�r Bathtubs No,of Moon Total HP ;?9t",i,4,1$4, ' ` "`
r .. . ��JL,�� , _,fir
OTHER'
A iiii 4�vdss er ale rqv!riti by thf&uscter 4wirtr,
Estimated Value of i oil Work: - C, ' (Whorl required by municipal policy.)
Wotk t0 Ktrrt. Inspections to be requested in accordance with MEC ltd.10,and upon completion.
tN tUnless waived by the owner,no permit for the perlbrmonor of electrical work may issue union
Co liana*provides proof of liability insuron oe including operation"coverer or its etlelnndal squtvalerrt. The
undesired matinee that such coverage to in fawn,end halm:WSW proof of scm*to the permit bolas oMee.
CHECK ONE. INSURANCE fa SOND 0 OTHER Ca (Spsoll5n)
I Nsfagr Os ribs miPIMA OP*Ifi.r,►that m►pip l nfution ere Has ryylitorrcon k ow*
FIRM NAlitat LAC.11404 1,1 n g 1.A
LIC.Nt2+ws
LIcNNOS $jc. Mpllyd fl�rantow *x rr ►rr;.
a topplicaiWW,o,,sour,`moo SW*akin.mother NO 1Nre,Teal.No. T' „
Addr�etset .P toils. �l o 4" * V n�1 M i s )44. d . _ AIt.`4`el.No.t
M.O c,14 ,e , r Dimw o ic "Ss Liore : tic,No. r ,.
OWNER'S INSURANCEWAr1E t 1 art aware*et the UMW doer,not haw the liability ., cotes
trrwatig4em . By my stratum r'e mow,1 hereby weir*this requirement. 1 am the( anti a t e-mac
Sign Nate Teiepytaotae
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