HomeMy WebLinkAboutBLDE-23-004545 Commonwealth of Official Use Only
L. ,,t'') Massachusetts
Permit No. BLDE-23-004545
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:2/15/2023
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) 18 KATHARYN MICHAEL RD 3 (p0-+ 4144 34Z S7
Owner or Tenant GARDENS ASSN INC elephone No.
Owner's Address PO BOX 216, YARMOUTH PORT, MA 02675-0216
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) ,
Purpose of Building Utility Authorization No. 1 t1 7 8 LI
Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Me ers/ &/y0
New Service 100 Amps Volts Overhead 0 Undgrd El No.of Meters "exis_tL
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install meter pedestal, panel, &receptacle&light for shed. `1(27(2 j
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 1 Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets 1 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 Eauivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Signs _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: REILLY ELECTRICAL CONTRACTORS
Licensee: Sean Reilly Signature LIC.NO.: 22960
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 14 Norfolk Avenue, Eastson MA 02375 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 ❑ owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $100.00
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Commonwealth o/f'/laddachudettt Official Use Only
1 .2Separtment o/.}ire Serviced Permit No. �= -�"--C
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(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2/15/2023
City or Town of: Yarmouthport 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) 18 Katharyn Michael Road R e_c2.,t"
Owner or Tenant The Gardens Assoc., Inc. Telephone No.
Owner's Address P.O. Box 216 -Yarmouthport, MA 02675
Is this permit in conjunction with a building permit? Yes ri No V (Check Appropriate Box)
Purpose of Building Commercial Utility Authorization No. 11797885
Existing Service Amps / Volts Overhead Ti Undgrd g ❑ No.of Meters
New Service 100 Amps 120/240 Volts Overhead
❑ Undgrd [2. No.of Meters 1
Number of Feeders and Ampacity 1 @ 100A
Location and Nature of Proposed Electrical Work: Install new meter pedestal, interior panel and service lateral from
utility pole to shed. Install receptacle and light fixture within shed.
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- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. 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 Ill Other
No.of Dryers Heating Appliances Kam, Security Systems:*
No.of Water No.of Devices or Equivalent
No.of No.of
Heaters KW Wiring:
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: $ 4500 (When required by municipal policy.)
Work to Start:2/15/2023 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 coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties ofperjury,that the information n this plication is true and complete.
FIRM NAME: Reilly Electrical Contractors, Inc.
LIC.NO.: 556 Al
Licensee: Sean Michael Reilly Signature
(If applicable, enter "exempt"in the license number line.) LIC.NO.: 22960-A
Address: 14 Norfolk Avenue,Easton,MA 02375 Bus.Tel.No.:508-394-3211
T .
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lio No.No.: 508-400-8936
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 ❑owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE: $ I