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Home My WebLink AboutBLDE-22-002472 . - Commonwealth of Official Use Only -*,::57i Massachusetts Permit No. BLDE-22-002472 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:10/30/2021 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 a .0X Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box Purpose of Building Utility Authorization No. 5376942 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: Replace exterior service equipment. 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 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 ❑ 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: MICHAEL YOUNG Licensee: MICHAEL YOUNG Signature LIC.NO.: 22314 (I/'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 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 Qtc t kl yls( L ,Caady ler RECEIVED lnfi0P6h ,, .1, OCT 29 2021 nwaa /M�aachudatte Official Use Only -7 -"_II t a?aruisenb a —Firs Serviced 1� Occupancy and Fee Checked .. BOARD OF FIRE PREVENTION REGULATIONS jRev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 7 CM 2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /o -y '7 City or Town of: YARMOUTH To the Inspe or of Tres: By this application the undersigned gives notice of is or her intention to perform the electrical work described below. Location(Street&Number) ,3'3 o it-? lid, - 1 Owner or Tenant _SL/S14lev/ --r Telephone No. '7 -filit-d i CQ v.l Owner's Address ,P /)7//rwir114 PL f All? ei/2X .\ ,rVA VL Is this permit in conjunction with a building permit? Yes ❑ No .Check Appropriate Box) Purpose of Building Utility Authorization No. 3'3 7 ' y '. Existing Service/O 7 Amps /:„ ) /, '/iVolts Overhead Undgrd D No.of Meters / New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ,/,'; f 7 J -e / v- a` 3 eu/i J,7n / ,�621l',f XO l i8 /12z'7 _ No v) Completion of the followingtable may be waived by the Inspector of Wires. W No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans No.of Total ,ram/ Transformers KVA .! No.of Luminaire Outlets No.of Hot Tubs Generators KVA n �._ No.of Luminaires Swimmingpool Above In- No.of Emergency Lighting grnd. ❑ grad. ❑ Battery Units `1 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 1 k r 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 0 Municipannection ❑ Other, Co 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: 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 covers orce,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) I certify,under the ins and pej°l'es of perjury,that th formation on this application is true and complete. FIRM NAME: )nwvt,- Y,0%ei?J/!➢ ( .c, . .rt.,/ LIC.NO.: ��3icf/ - Licensee: ///e�i Z �,� Signature s ,i,!� /LIC.NO.: Q a' (If applicable,en e!r"ere pt"in the l' ense number line.) / - Bus.Tel.No.. 7 —a?�/O� Address: l' -,5 77'6T Z LLdrrST /5.eit/S.:7 -,,1/s, Alt.Tel.No.: *Per M.G.L.c. 147,s. -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 ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$