HomeMy WebLinkAboutBLDE-24-1039 Commonweatlfs of 1/laaeacluo.tts Official Use Only7,77:7 /f(��
` ! c� c� Permit No. — 3--,
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* �,i Permit
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• \\"�� �., $, BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] leave blank
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,AI/ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
e1 All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
1
66 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7/5/2024
k -a City or Town of: West 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.
p L � Location(Street&Number) 117 Wimbledon Dr
4+ Owner or Tenant Gary Pike Telephone No. 508-400-5403
Owner's Address an Frir1y qt Aiihu,rn MA n1Fo1
p Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)
i Purpose of Building Dwelling Utility Authorization No. 17s94386
Existing Service 200 Amps 120 / 240 Volts Overhead __X, Undgrd No.of Meters 1
New Service 200 Amps 12o / 240 Volts Overhead L Undgrd ,i, No.of Meters 1
JNumber of Feeders and Ampacity 3. no amp
kLocation and Nature of Proposed Electrical Work: Change service from over head to underground
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kft Completion of the followinyitable may be waived by the Inspector of Wires.
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No.of Recessed Luminaires No.of Ceil Susp.(Paddle)Fans No.of Total
:
? Transformers KVA
C.1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA
tC.t Above In- No.of Emergency Lighting
4:' No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
t No.of Switches No.of Gas Burners `No.of Detection
and
,� Initiating Devices
Ili No.of Ranges No.of Air Cond. TonTotal
s No.of Alerting Devices
No.of Waste Disposers 'Heat Pump Number Tons KW No.of Self-Contained
p Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
Connection
No.of Dryers Heating Appliances KW Securitys:*
f Devices or Equivalent
'Ni.of Water No.of No.ofKW Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.H dromassa a Bathtubs No.of Motors Total HP TelecommunicationsNofDeviesor qui g:
y g No.of Devices Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 2500 (When required by municipal policy.)
Work to Start: 7/8/2024 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 of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
Licensee: Jerry Cronin Signature --"'f(._.---- LIC.NO.: 39785E
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.'
Address: 146 OYtord St N Auburn AAA 01 01 Alt.Tel.No.: 50a-720-geoo
*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 LPERMIT FEE: $
Signature Telephone No.
SEC_ ' 1, VED �tL
7�1
JUL 05 2024
BUILDING DEPARTMENT