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Home My WebLink AboutBLDE-22-004573 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-004573 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:2/17/2022 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) 172 BLUE ROCK RD Owner or Tenant Mark Stoever Owner's Address 172 BLUE ROCK RD, SOUTH YARMOUTH, MA 02664 Telephone No. Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropri e Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 o M45 et New Service Amps Volts Overhead 0 Undgrd 0 e Number of Feeders and Ampacity t� Location and Nature of Proposed Electrical Work: Install outlets on dock. Completion of the following table may be weV . o Wires, No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Transformers No.of Luminaire Outlets No.of Hot Tubs ,:7),fr Generators No.of Luminaires Swimming Pool Above ❑ Qrnd. CI Battery of Emergency Ligh No.of Receptacle Outlets Battery Units p No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Ballasts Data Wiring: Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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 1 certify,under the pains and penalties o (Specify:) fperjury,that the information on this application is true and complete. FIRM NAME: Licensee: Nicholas McEloy Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 22642 Address:31 Captain Carleton Road, Cotuit Ma 02635 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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 FE :$50.00 J Commonwealth o yy�aieach/ ilkw //ludea Official Use Only '` '• Aparimeni of Serviced Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M C),5 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INYiF�OR AT� ) Date: aZ V�f o ja City or Town of: 1-( ' By this application the undersigned g' es notice of his or her intention to perform h electrical e Inspector w tides gibed below. Location(Street&Number) i or a Kt_ Owner or Tenant Owner's Address Telephone Noe325902.. Is this permit in conjunction with a building permit? Purpose of Building_____________ Yes ❑ No (Check Appropr iate Box) Utility Authorization No. Existing Service Amps _._ / Volts Overhead ❑ Undgrd 0 No.of Meters New ervi a Amps iVolts Overhead❑ Undgrd ❑ No.of Meters — Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: C� Cam,lesion o the ollowin table ma be waived b the Inspector o Wires. No.of Recessed Luminaires No,of Cell.-Susp.(Paddle)Fans `o.o ota No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool , ' 'Ve n- 'o.o mergency .ng rnd. � ,rnd. � Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 'o.o etec on a • No.of Ranges Initiatin Devices No.of Air Cond. o No.of Alerting Devices No.of Waste Disposers Det Tons eat 'temp ' i Oq8 r ., o.o e on n:, Totals; et No.of Dishwashers ection/Alertf Devices Space/Area Heating KW Local❑ .un c pa El No.of Dryers Heating Appliances KW dear ty Cys ems: an Other `o.o "ater No.of Devices or E•uivaleat Heaters KW °'o `o•o Data Wiring: Si •a Ballasts No.of Devices or E No.Hydromassage Bathtubs No.of Motors • uivaleat �'ota!HP a ecommun ea�ons �' ,g OTHER: No.of Devices or E• ivalent Attach additional detail jfdesired,or as required by the Inspector of Wires, Estimated Value of ectrical Work: j"j' Work to Start: oZ o? (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion INSURANCE CO E GE: 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 63 BOND 0 OTHER 0 1 cet ii�:0 fP perjury, under the pains and penalties o u that the information on this application is true and com le FIRM NAME, tY, Cape Cod Electrical P Licensee: N i c iC M c F l r o vLIC.NO,; 2 2 g 4?_ e Signature _ ,%7--—--- LIC.NO.:870 M (Business) (If applicable,enter exempt in the license number line.) Address: 381 Old Falmouth Rd Ste 32 Marstons s. MA 02648 Bus.Tel.No.: 508-S66-4489 Addis *Per M.G.L.c. 147,s.57-61,security work requires Department of Pubic Safety" lS"License: Lic.No, Alt.Tel.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 III owner uiredOwner/Agent Signature ■ owner's a� t. Telephone No, PERMIT FEE:$ 3-0. 1 Email: Office@capecodelectrician.com