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Home My WebLink AboutBLDE-21-005740 Commonwealth of Official Use Only Permit No. BLDE-21-005740 0E 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:4/6/2021 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) 10 SURFSIDE TERRACE Owner or Tenant GRIMES THOMAS A Telephone No. Owner's Address 12 WINDSOR RD, EAST WALPOLE, MA 02032 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check it p iate Box) Purpose of Building Utility Authorization No. 3 Existing Service Amps Volts Overhead 0 Undgrd 0 fe No. ^____ New Service Amps Volts Overhead 0 Undgrd 0 • i • Number of Feeders and Ampacity P , -C , i W I Location and Nature of Proposed Electrical Work: Re-feed guest house Oi t Completion of the following table may be waive el •pt•r of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 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: 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 .---Fet1/4014 etwour 47174 P ,— (, /(h ei /ueette Official Use Only ` i om a aeeac &Zj -t57`i 0 ,.. • a +r c� Permit No. apartment of ire Serviced ;; Occupancy and Fee Checked •,,, BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] 1/41/4 (leave blank) \A APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M C 527 C R 12.00 (PLEASE PRINT IN INK OR TYPE 1 INFORMATION) Date: &7 City or Town of: frig feuTh To the Insp for Wires: By this application the undersigned gi es notice of his or her intention to perform the electricalelwork described below. Location(Street&Number)j ' /) ,f ZJ,C s! f j C/ AA-ea jj A "fro Z eU t Owner or Tenant 7""i,, < 'rn ' f Telephone No. SOF:—902j—/B,o Owner's Address /2 JzN S'�n fr) '7"/40,41 ep ,A. ®a2D o"Z Is this permit in conjunction with a building penal/ Yes �"1Vo ❑ (Check Appropriate Box) '- _, icL-Purpose of Building ' ' /97WJ Utility Authorization No. Existing Service(20O Amps /di l 0,70 Volts Overhead❑ Undgrd[— No.of Meters / , N. Yew Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /6 cG elT A L S'A---- om Completion of the followbuktable mg be waived by the Ingsector of Wires. vi No.L3 No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Transformers KVA Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA AboveIn- No.of Emergency Lighting A:" No.of Luminaires Swimming Pool grad. ❑ ernd. ❑ Batter,Units `I No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS No.of Zones ` 'No.of Detection and No.of Switches No.of Gas Burners Initiating Devices I k.! No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers "Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices M No.of Dishwashers Space/Area Heating KW Local 0 Connunidpection 0 Other. No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of WaterKW No.of No.of Data Wiring: Haters Signs Data No.of Devices or Equivalentrg No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNoDevkxs 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: 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 cov in force,and has exhibited proof of to the permit issuing office. CHECK ONE: INSURANCE' BOND 0 OTHER 0 (Specify:) �, �, - j � I I c under the and o a ,that the formation on th Ppflc�a tion&true and conp e. l FIRM NAME: 1 /6/0 t f If/re_ cfJA.,9— . Je- LIC.NO.:,'e2Jf y A Licensee: _„f �� Signature _" 14 LIC.NO. .. (If applicable,eat er�efpt' ' th. tcense her line.) , ' Bus.TeL No.• 7 Qwr• l Address: / if '7,,� L 1/ix/ s �� .e Alt.Tel.No.: �4`P *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)0 owner 0 owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.