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Home My WebLink AboutBlde-21-003636 Commonwealth of Official Use Only Permit No. BLDE-21-003636 1 Massachusetts 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:1/4/2021 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) 42 SPRINGER LN Owner or Tenant Brooke Paulsen Telephone No. Owner's Address 42 Springer Lane,West Yarmouth, MA 02673 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: Rewire kitchen&bathroom. 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.0 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 Signs 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 ,� (/ /2 ,tZ., Pnunsoussa simamac/mos& �-�Official Use Only, J. ' v Permit No. l� 24 —3(3� .� ...; ant 43i..sraCif Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) v 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: ),?-/a-/c�-(,' City or Town of: Yet rmn i M rn ri To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. GI Location(Street&Number) 1.0.. c pry iwY (4�I e. ri Owner or Tenant J pa(, yi Telephone No.S9 -At-10`L SS'Z rill:- a, Owner's Address £1d3 c pv If1 t y LaiY(L F Is this permit in conjunction with a hsdhg permit? Yes No 0 (Check Appropriate Box)(2)IN i 1 G)i►tl Ycrm' tS Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ o. f V New Service Amps ! Volts Overhead❑ Undgrd❑ N No.ofo Meters Number of Feeders and Aspa dty A Location and Nature of Proposed Electrical work 14e ry „v e cl c L)&. \ k n Q.. h ed r o c m 5 ax.6, C.e 1 t,vN. . VK 0.k_ W► r 't n 'k>l%�r S W i +C hit.S -VC C o CI . l ICA+c4Vt f r c.,O bc ied-hi v fop of fo table be waived by due tnTspector of Wires. 113 No.of Recessed Luminaires No.of CelL-Snap.(Paddle)Fans No. KVA t KVA '1 No.of Luminaire Outlets No.of Hot Tubs Generators r1 Above In- Pro.of Kmergeacy Lighting 4... No.of Lasinaires Swimming Pool oat ❑ wad, ❑ Battery Units No.of Receptade Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Berner: . No.Ifs Devices S. t= No.of Ranges No.of Mr Cond. Total No.of Alerting Devices No.of Waste Disposers Heatab Number'Tons _KW_ No.ND tedion/Self-Contained No.of Dbltwasles Space/Area Heating KW Local 0 CMosaectioa 0 Other No.of Dryers Heating Appliances KW SenNo.of f or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Sias Ballasts No.of Devices or ' . - t onsNo.Hydromassage Bathtubs No.of Motors Total HP �elecommev • ` , No..o of f Devices or ' , , OTHER: Attach additional detail if desirest or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) 1 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND 0 OTHER 0 (Specify:) I cerdfr,wider the pains and p ofpoppy,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee:p "(t Signature I AJJZl/�C.NO.: Of applicab enter"exempt"in the license number line.) Bus.Tel.No.: Address: Mt.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)E owner ❑owner's agent. SignatureOwne Telephone No. Sty 1.1104 cs 21 PERMIT FEE:$ Elliott, Ken From: Elliott, Ken Sent: Saturday, December 19, 2020 1:15 PM To: 'Brooke Paulsen' Subject: RE: Electrical Inspection-42 Springer We have received your application to perform electrical work but there was no fee included with the application. Until we receive the appreciate fee,for the work being done, I cannot process the application. K. Elliott Inspector of Wires Town of Yarmouth, Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 (Extension 1263) kelliott@yarmouth.ma.us From: Brooke Paulsen [mailto:brookepaulsen2425@gmail.com] Sent:Wednesday, December 16, 2020 9:12 AM To: Elliott, Ken<KElliott@yarmouth.ma.us> Subject: Electrical Inspection-42 Springer A *ntl l o ginat�es outside bf the"or. t bi i no 'open'attachments o clic1 Pt a ou are sure th em al "iiih4:0 nownsende.and you kno *0!content'zis safe. ` I the sender to ve u . Otherwise delete"this a i A4 liisaUv a P aw r' 9E. Y U6p Good Morning Mr. Elliot, I submitted an electrical permit application this week, but the gentleman signing people in at the door collected this from me rather than allowing me into the building department office. I first wanted to make sure you got the paperwork, but I'd also like to schedule an inspection when you are available. Please let me know if you have any questions. Thank you, Brooke Paulsen 508-240-4552 1