HomeMy WebLinkAboutBLDE-23-006153 d ..fie✓ y , Commonwealth of Official Use Only
Massachusetts PermitNo. BLDE-23-006153
'i...- BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
f 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:5/7/2023
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) 33 TANGLEWOOD DR O
Owner or Tenant MICHAEL LENANE Telephone N
Owner's Address r,
Is this permit in conjunction with a building permit? Yes El No 0 (Chec a
457.
Purpose of Building Utility Authorization No.
Existing Service Amps Volts ON erhead ❑ Undgrd ❑ No.o i e ti� •
New Service Amps Volts Overhead 0 Undgrd 0 No.of Met:
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install lighting per attached.
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- I: 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 ❑ (Specify:)
I certify,under the pains and penalties ofperjury,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
(4 L/23 (rc4 ' 4t
' g4 Commonweal of/rtassachudetie },Official Use Only
i !'v� �c]7 Permit No.t-�3'6 i -✓
.2)epartment a`Jire Serviced
•Lite Occupancy and Fee Checked
;1• 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( C),527 MR p12.00
(PLEASE PRINT IN INK OR TYPE LL INFORMATI9 N Date: a g"-�J
City or Town of: �rn7-ev�`fi To the Inspe for of cues:
By this application the undersigned giv s notice of his or her intention to perform the electrical work described below.
Location(Street&Number)) , �Jf te Le)OOCE, ])r'
Owner or Tenant 141 1 C4Qe j 'la h-� Telephone No.417-799 p'7 77
Owner's Address
Is this permit in conluc(tion w a bul Ing peirmit? Yes 0 Nod (Check Appropriate Box)
Purpose of Building -es( En LC L. Utility Authorization No.
Existing Service Amps / Volta Overhead❑ Undgrd 0 No.of Meters
)slew Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity / "ad
Locatio and Nature of Proposed Electrical Work: t ', i,1 ' ' 'e v $ ) r,
(:y } (� .I i,& i 1 a, u� JA 4 'P�Lf' 0 0 t'h
uCam,letlona the ollowln:table be aired b the Ins, roue Wires.
1.>1
..of Recessed Luminaires No.of Ceil.•Sus . addle)Fans 'ra o o aP(P Tramformers KVA
L. o.of Luminaire Outlets No.of Hot Tubs Generators KVA
., .'� n i Above In- Emergency Lighting
- No.or Eme ea to hnv
„_: ' t'o,of Luminaires Swimming Pool grad. ❑ grad ❑ Battery Units
W E o.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No,of Zones
tY - ' Burners
-- -" o.of Switches No.of Gas i of Detection and
Initiating Devices
o.of Ranges No.of Air Cond. To No,of Alerting Devices
No.of Waste Dleposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Ales4Devlces
No.of Dishwashers Space/Area Heating KW Local❑C un airs ❑Other
No.of Dryers Heating Appliances KW Security
o.of vices or Equivalent
'o.of Water KW o.of No.of Data Wiring:
Heaters Signs Ballasts No.of Dever or Equivalent
No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring:
y g No.of Devices or Equivalent
OTHER:
Attach additional detail((desired,or at required by the Inspector of Wires.
Estimated Value o lee cal Work: o2e-od'- (When required by municipal policy.)
Work to Start: 7a Inspections to be requested in accordance with MEC Rule 10,'and upon completion.
INSURANCE CddVE C 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 ce►ti y,under the pains and penalties of perjury,that the Information on this application is true and corteple
FIRMNAME: Cave Cod Electrical LIC.NO.: 22642.A
Licensee: Signature LIC.NO.:67°Al(Business)
Nick McElroy g —��
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No. 508-566-4489
Address: 381 Old Falmouth Rd Ste 32 Menton 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. 1 am the(check one)❑owner p owner's a ant.
Owner/Agent I PERMIT FEE:$ 5� �
Signature Telephone No.
Email:Oftice@capecodelectrician.com