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Home My WebLink AboutBLDE-22-002549 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-002549 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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:11/3/2021 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 KATHARYN MICHAEL RD U Owner or Tenant LAZAREK ALBERT E Telephone No. Owner's Address LAZAREK ELIZABETH A, 33 KATHARYN MICHAEL RD C41A, YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 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: Exterior meter main &feeders.(HOUSE#33) 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Other: Connection ❑ No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: DARNELL CAULEY Licensee: Darnell Cauley Signature LIC.NO.: 11662 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:54 CAPTAIN BESSE RD, S YARMOUTH MA 026642805 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 my 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 Ce6i + 1 '24 o op c as i) Commonwealth.o/7addachudsttd Official Use Only k. . 2ti _X % c� c n Permit No. .:w: 2 slvartms,sf o� irs Jarvicsd ,;rs' Occupancy and Fee Checked Kr�st1 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: 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 eleccwork described below. Location(Street&Number) -33 `-i'hary r J&cC} ( Owner or Tenant Ai L_G-ZLi ri- K Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes r] No (Check Appropriate Box) Purpose of Building Utility uthorization No. Existing Service I Amps [a)/ Z((J Volts Overhead �1/ Undgrd n No.of Meters New Service (OD Amps kk /(A() Volts Overhead ril Undgrd ❑ No.of Meters t Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: {/vZW c)J-S,de. jA.<4 r ,fah c c a,t .0�C'c. �PP-Je NO Completion of the following table may be waived by the Inspector of Wires. ootal Ui No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.Transformers KVA :t No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of-Emergency Lighting A No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units `l No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners moo.of Detection and Initiating Devices 11.1 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipa ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:'F No.of Devices or Equivalent RK-OfWater KW No.of No.of Data Wiring: Heaters Sins Ballasts g 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: 1 I-1 " ` 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 ❑ OTHER 0 (Specify:) I certify,under th alns and ena ' s o perjury,that the Information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.: 1(66:)--1 (If applicable.entet 'exempt'in the*ens num¢¢��r tne.) Bus.Tel.No.• Address: 5 y (', 7 ,r l3S i"1 �:+�Jit 1/4t»,r t'11 til4 Oarv6Y Alt.Tel.No.: 7 7y--53 -65`i6 *Per M.G.L.c. 147,s. 547-61,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,1 hereby waive this requirement. 1 am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $