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Home My WebLink AboutBLDE-21-004219 Commonwealth of Official Use Only Permit No. BLDE-21-004219 E 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:1/28/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertomm the electrical work described below. Location(Street&Number) 11 WINCHESTER AVE Owner or Tenant Mike Kelley Telephone No. Owner's Address 11 WINCHESTER AVENUE,WEST YARMOUTH, MA 02673A n� Is this permit in conjunction with a building permit? Yes 0 No 0 (Cheek Appropriate B J1�6 I 46 v Purpose of Building Utility Authorization No. 4602724 tj 6 Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service. 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- o 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/Alertine 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 P Young Licensee: Michael P Young Signature LIC.NO.: 37999 (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: $50.00 M j Q-70./ \C'' Commonwealth of maeeacisueolie Oricial Use Only ,, --. :,/ c7� cc77 nn Permit No. ` `'`" \ '� ' �sparinnoni o`,}irs Jiwu se 9 I I-, 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(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: V.47r,A7/ City or Town of: YARMOUTH To the Inspector of : By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 1/ /J/4//4E,3 t- - Owner or Tenant /V/ l 4 Telephone No..3' .P, '434; \' Owner's Address // LTJ.nrckes izcyj 4J ftAleS7;1 112,01idL t 444 c i/6 7_ i' Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) a Purpose of Building ; .Z..,,, fort;/ce Utility Authorization No. gto'a 7,2 41 Existing Service/cc ci Amps Jalt: I dig Volts Overhead[Er Undgrd❑ No.of Meters ___L___ ' New Service /Ut! Amps /. i/.1.)4/.0 Volts Overhead Undgrd❑ No.of Meters I • - a Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: d"'. J L/'C- a s Completion of the followingtable may be waived by the lnpector of Wires. Total ilk No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Tof Transformers KVA W. No.of Luminaire Outlets No.of Hot Tubs Generators KV/► In- s No.of Luminaires Swhnming Pool Above o In- ❑ No.of l;roergeney Lighting crud. grnd. Battery Units J No.of Receptacle Outlets No.of OH Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices IQ No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons ,_KW _ 'No.of Self-Contained Totals: - Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 MonnecunidpUtion ❑ Other, C 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 desireg 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 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: a.,,.L- Ae Z.:0 : 4,0 7-i e zias .4---- LIC.NO.: .77?y% c, Licensee: Iii /,f L Vt./ t.) .-� Signature - / �.•,— ,,,,‘,,,,,/ IC.NO.: (If applicableenter' t"9 the li erase num line.) Address: /3 Z' [- M_) ' 721-7L d1 S/ IS A€,%J/)37 P , el-- At.Tel.No.: 77 V-991-„? �(tj 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. PERMIT FEE:$