HomeMy WebLinkAboutBLDE-23-001562 Commonwealth of Official Use Only
. , Massachusetts
Permit No. BLDE-23-001562
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:9/26/2022
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) 665 WILLOW ST
Owner or Tenant NEWTON ROBERT L Telephone No.
Owner's Address WEISS MARSHA E,405 FRONT ST, LINCOLN, RI 02865
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 ❑ Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install whole house generator.
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
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
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 Equivalent
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:
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: $50.00
tom' LLI ' 541- � , ,)
eeb l( f t(Z lit-
Commonwealth o`Maeeachadette Official Use O y
1• ' .1 ryy nn Permit No. 2-I'D(.0 Z-
B�
2rpartrnent el3ity Jeevkao
I1 '' Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 C 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: // a a
City or Town of: L&file 0� To the Inspector of res..By this application the undersigned gives no ce of hh''s or her intention to perform the eleccttri,l work described below.
Location(Street&Number) CO to 5 1 i//ow rsZT-
Owner or Tenant )q o ..e.kJ 4-0 P) Telephone No.5Qi•a rf 7.33&;;;
Owner's Address r�,/
Is this permit in conjunction with bundling permit? Yes ❑ No (� (Check Appropriate Box)
Purpose of Building 1Qe$( en t/6L L. Utility Authorization No.
Existing Service Amps / Volts Overhead E Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
Number of Feeders and Ampaclty Location and Nature of Proposed Electrical Work:all 544l( U,Ii di< hoary ) 7.P I'..e4,Gf/41ry••
Completion of the followin,table mg be waived by the Inspector of Wires.
No.of Total
No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires SwimmingPool Above ❑ In- 0 No.of Emergency Lighting
ernd. grad. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.In Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Tons! No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons,,,_....KW No.of Self-Contained
P Totals: Detection/Alertiln!g.Devices
No.of Dishwashers Space/Area Heating KW "cal 0 Volnne tin 0°ther
No.of Dryers Heating Appliances KEY Sec Ns:*
o.of Devices or Equivalent
No.of Water Kam, No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.H dromassa aBathtubs No.of Motors Total HP 'telecommunications fDevictsorEquly
y g No.of Devices or Equivalent
OTHER:
vO Attach additional detail I(desired,or as required by the Inspector of Wires.
Estimated Value of teethe I Work: '/0 0' (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE C VE 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® BOND 0 OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and comple
FIRM NAME: Cape Cod Electrical LIC.NO.: 22642-A
Licensee: Signature LIC.NO.:67°Al(Business)
Nick McElroy 8 —� ---��
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.• 508-566-4489
Address: 381 Old Falmouth Rd Ste 32 Marston Mills MA 02648 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)0 owner 0 owner's agent.
Owner/Agent I PERMIT FEE:$ ��.00
Signature Telephone No.
Email:Office@capecodelectrician.com