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Home My WebLink AboutBLDE-21-005381 -�; .. Commonwealth of Official Use Only ICI% Massachusetts Permit No. BLDE-21-005381 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:3/19/2021 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) 33 SHORE RD Owner or Tenant DOLINER SUSAN Telephone No. Owner's Address DOLINER SUSAN, 20 MERRIMAC PL, CAPE ELIZABETH, ME 04107 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. 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: Wiring for kitchen,bath rooms, laundry, &sitting area. 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- ❑ 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 Data Wiring: Heaters Siens Ballasts 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: MICHAEL YOUNG Licensee: MICHAEL YOUNG Signature LIC.NO.: 22314 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 156 CAPES TRL,WEST BARNSTABLE MA 02668 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 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: $75.00 Co Ltrigi IV/7124 Itg/ � 17-1 I 1. _( , Conunomw.altl►o`%�aeeac�iaeslfd Official Use Only 14 .y e�� Permit No - 3 \\�� ? .[1.par�in.nt o� tin�pYlttR t; Occupancy and Fee Checked ,i BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) LI p� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK V Ali wort to be performed in accordance with the Massachusetts Electrical Code(MEC),527 C R 12.00 (PLEASE PRINT IN INK OR TYPE A INFORMATION) Date: 31/ - / N City or Town of: itAPiiid eJ ri To the Inspe for a o Wires: By this application the undersigned ' es notice of his or her inten'on to pert° the electrical work described below. Location(Street&Number) 3., 2e �.[) 41 p 5-7- Arm ezi jr-"A ' Owner or Tenant ,,571../5,47^-, / j//N/L- " . Telephone No.,5?.i - 922-/36., Owner's Address ,,,U /r'1 C/af iv1 A PL. E a 2 46i Ih A E n Y/6 7 ., Is this permit in conjunction with a b ,ii, permit? Yes No El (Check Appropriate Box) Purpose of Building /`et4tu l)J Utility Authorization No. Existing Service ld o Amps /o?o/ oz kVolts Overhead[ndgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: 4..//;e_d, A24,,, tlj/„,A)�?3 2i ,er)5 C,,,,,,/?t .. 7 S! 1-,,,/r- l ,- / Completion of the followin&table Iffi be waived by the Incector of Wires. litNo.of Recessed Luminaires No.of Cell. (Paddle)Fans No.of Total � -Sn�• Transformers KVA .Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA n Above In- No.of Emergency Lighting No.of Luminaires swimming Poo'mod. ❑ grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones `` No.of Switches No.of Gas Burners No.InDetengon and Initiatit[Devices 11,i No.of Ranges No.of Air Cond. Tunsl No.of Alerting Devices No.of Waste Heat Pump Numer b Tons KW No.of Self-Contained Totals: .".. Detection/Alerting,Devices No.of Dishwashers Space/Area Heating KW Local 0 lann tioa 0 Other No.of Dryers Heating Appliances KW Security Systems:* iy No.of Devices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Sys Ballasts No.of Devices or.Equivalent No.Hydromassage Bathtubs No.of Motors Total HP 'Telecommunications of Devisor Wiring: Ega eat OTHER: Attach additional detail if desirml or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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 coveraje.is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ND 0 OTHER 0 (Specify:) /ouAt.f / et/J-z'(- /a/ I I certify,under the and pe of perjury,that the fotitwtion on this application is true and complete. FIRM NAME: Q r.xJ£- 2.696,7 IP 11,E av i ,TJ/C LIC.NO.: ,..2,2 3/Lf , Licensee: le,1get. u, - Signature LIC.NO.: 3? 9 .2, 6--- (If applicable,enter" t in he icenseryu�eber line.) Bus.TeL No.: 71Y-if'V- 2Va Address: tile Z,P63 rIZA-i L /k?f 7-- 801)(nf 5'77964 A- 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)[]owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$