HomeMy WebLinkAboutBLDE-22-000241 Commonwealth of Official Use Only
‘ Massachusetts Permit No. BLDE-22-000241
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:7/14/2021
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) 5 LOOKOUT RD
Owner or Tenant ARPANO MICHAEL A Telephone No.
Owner's Address ARPANO SHARON, 5 LOOKOUT RD,YARMOUTH PORT, MA 02675-1015
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No. b Z3 3j l
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: Re4locaqte service attachment&meter socket due to replacement siding.
Completion of the followi tcr, aived b the Inspector of Wires.
4
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total
Transfo lekKVA
No.of Luminaire Outlets No.of Hot Tubs Generator ��KVA
No.of Luminaires Swimming Pool Abovc 0 In- 0 No.of Emerggh
grnd. krnd. Battery Units o
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I V Q
No.of Switches No.of Gas Burners No.of Detection an'f O
Initiatine Devices
No.of Ranges No.of Air Cond. Total
n No.of Alerting Device
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 0
Totals: Detection/Alerting Device
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 0 BOND ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: MICHAEL J MCSHEFFREY
Licensee: Michael J Mcsheffrey Signature LIC.NO.: 9897
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 1 LEONARD CIR, MANSFIELD MA 020482754 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. i
Owner/Agent
Signature Telephone No. PERMIT FEE: $50.00
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Commonwealth,
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• 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 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: July 13, 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) 5 Lookout Road
Owner or Tenant Michael &Sharon Arpano Telephone No. 774-722-3958
Owner's Address 5 Lookout Road,Yarmouth Port, MA 02675
Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box)
Purpose of Building Residential Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead n Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Relocate service attachment and meter for siding replacement
Completion of the followingtable may be waived by the Inspector of Wires.
otal
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle Tf T)Fans Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above 1-1 In- No.of Emergency Lighting
grncl. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
of
No.of Switches No.of Gas Burners No. InDete and
Initiatinnggon Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
g Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
p Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other
P Connection
No.of D ers Heating Appliances KW Security Systems:*
�Y No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters KW Signs Ballasts No.of Devices or Equivalent
dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.H
Y g No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: $450 (When required by municipal policy.)
Work to Start:7/15/2021 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:) GENERAL ACCIDENT INSURANCE Exp:07/31/2021
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: REILLY ELECTRICAL CONTRACTORS, INC. LIC.NO.:9897A
Licensee: MICHAEL J. MCSHEFFREY Signature INC.
LIC.NO.:9897A
(If applicable,enter "exempt"in the license number line.) L Bus.Tel.No.:508-394-3211
Address: 110 OLD TOWNHOUSE ROAD,SOUTH YARMOUTH,MA 02664 Alt.Tel.No.:508-00-8936
*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)❑owner ❑owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $