HomeMy WebLinkAboutBLDE-24-1199 COMMOtU000114 o/FlladdetChudalfd Of�fic`ial�Use
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(( Occupancy and Fee Checked
5BOARD 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: 7/31/24
City or Town of: South 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) 31 Captain Bearse Rd.
Owner or Tenant William Cormier Telephone No. 508-864-7638
' Owner's Address
gIs this permit in conjunction with a building permit? Yes H No X❑ (Check Appropriate Box)
Purpose of Building Residential Utility Authorization No. 18257729
Existing Service 100 Amps 240/ 120 Volts Overhead I5 I Undgrd_ No.of Meters 1
New Service 200 Amps 240/ 120 Volts Overhead C Undgrd ❑ No.of Meters 1
Number of Feeders and Ampacity
CJ Location and Nature of Proposed Electrical Work: Service upgrade - 100amp to 200amp
V Completion of the following fable may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.-Sus . Fans No.of Total
p (Paddle) Transformers KVA
ct No.of Luminaire Outlets No.of Hot Tubs Generators KVA
a
k No.of Luminaires Swimmin Pool Above ❑ In- ❑ No.of Emergency Lighting
g grnd. grnd. Battery Units
J No.of Receptacle Outlets No.of OU Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No. Initiatinnggon Dete and
In Devices
Tota111 No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices
No.of Self-Contained
No.of Waste Disposers H�Totals Number Tons ' Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Connectionpal
❑ Other
Connection
App
liances of Dryers HeatingA liances KW Security Systems:*
No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters KW Signs Ballasts No.of Devices 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 if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: $4,000.00 (When required by municipal policy.)
Work to Start: 8/3/2024 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force,and has exhibited proof of sat i• to the permit issuing office.
CHECK ONE: INSURANCE 17,1 BOND 0 OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the Information on th' ' p ' 'ti',/ is true and complete.
FIRM NAME: Mercier Electric Co., Inc. t LIC.NO.: 809A1
Licensee: James R. Mercier Signature LIC.NO.: 16075A
(if applicable,enter"exempt"in the license number line.) Bu Tel.No. 508-792-9200
Address: 139 Southbridge St. Auburn, MA 01501 A Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of P }I'c Safety" V icense: Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee ices not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)El owner ❑owner's agent.
Owner/Agent Signature Telephone No. PERMIT FEE:$ 0() ,!W�\