HomeMy WebLinkAboutBLDE-23-16001 6/6/23,7:18 AM about:blank
„ , Commonwealth of Massachusetts 011'17-44
* Town of Yarmouth z , '
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ELECTRICAL PERMIT
Job Address: 12 FAIRWIND CIR Unit:
Owner Name: BUELLER COLLEEN I C�
Owner's Address: 12 FAIRWIND CIR Phone: Errlatl: R
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-16001
Existing Service Amps I Volts Overhead 0 Underground❑ No. of Meters:, ''�
New Service Amps/Volts Overhead❑ Underground 0 No.of Meters:` ,,
Description of Proposed Electrical Installation: Replacement boiler i
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type:
No. Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA:
Space Heating KW: Heating Equipment KW: , No.Motors: Total HP: Total KW:
No. Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices:
Swimming Pool: In-Grnd.❑ Above-Grnd.❑ Hot Tub❑ No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: 1 Video System ❑ No.of Devices:
No.Air Conditioners: Total Tons: Telecom System ❑ No.of Outlets:
No. Energy Storage Systems: KWH Storage Rating: , Security System ❑ No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:
No.of Modules: Roof-Mount❑ Ground-Mount❑ Level 1 0 Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $800 Work to Start: June 6, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: NICHOLAS MCELROY License Number: 22642
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: Sandwich, MA, 025632606 Sandwich MA 025632606 Fee Paid: $50.00
Email: office@capecodelectrician.com Business Telephone: 508-566-4489
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.
INSURANCE:
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StX Commonweaflh Of r//aaaachiadet(e Official Use Only
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BOARD OF FIRE PREVENTION REGULATIONS {RevOc.cu I/07]pancy and Fee Checked(leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be perforated in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE LL INFORMATI N) Date: oLG./a 3
City or Town of: a_A--trf 0 To the Ins eetor of Wires:
By this application the undersigned giv s notice of his or her intention to pee orm the electrical work described below.
Location(Street&Number) Pat. rkji rid C l�I?I/�n�
Owner or Tenant C o I -fie/) O Ut0 l/f,r Telephone No s0? o 5 -
Owner's Address
Is this permit in confuncVon with a building permit? Yes El No (Check Appropriate Box)
Purpose of Building ( . ( 'ice..f Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters _
New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters
Number of Feeders and Ampacity /',
Location and Nature of Proposed ElectricalW
Work: c d C hOj( (Y.-
-Completion of thefollowingtable may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of COL-Snap.(Paddle)Fans No,ns Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Above In- No.of Emergency Liganng
No.of Luminaires Swimming Pool gro& ❑ gross ❑ 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
initiatingg D Devices
No.of Ranges No.of Air Cond. Tot No.of Alerting Devices
ro treat Pump Number Tons..,. KW No.of Self-Contained
No.of Waste Disposers Totals: Detecdoo/Alerda[Devkq
No.of Dishwashers Space/Area Heating KW Local❑C nooTigev-11 0 Other
No.of Dryers Heating Appliances KW SecNa of kestloornEquivalent
No.of Water KW 'No.of No.of Data Wiring:
Heaters Signs Ballasts Na of Deviega or Ennl sknt
No.Hydromassage Bathtubs No.of Motors Total HP -Tel No.
Devices
r&alWIriet
Na of Dovlca or Equtvdeet
OTHER:
oa Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of lectri al Work: ‘rqd' (When required by municipal policy.)
Work to Start: 93 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE CO ERAGE: 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 0 (Specify:)
I cert(/y,under the pains and penalties of petjury,that the information on this application Is true and conspire
FIRM NAME: Cape Cod Electrical LlC.NO.: 22647-A
Licensee:Nick McElroy Signature LIC.NO.:670 Al(Business)
(If applicable,enter"exempt"In the license number line.) Bus.Tel.No: 508-566-4489
Address: 381 Old Falmouth Rd.Sb 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 gent.
Owner/Agent PERMIT FEE:$ �'�
Signature Telephone No.
Email:Office@capecodelectrician.com