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HomeMy WebLinkAboutBLDE-22-006692 y- ,V` Commonwealth ofOfficial Use Only rI.-.,,t Massachusetts Permit No. BLDE-22-006692 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 1Rev.l/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:5/19/2022 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) 1 FLORENCE LN Owner or Tenant BROWN MICHAEL D Telephone No. Owner's Address BROWN DEBORAH L, 29 WILSHIRE CIR, DRACUT, MA 01826 Is this permit in conjunction with a building permit? Yes 0 No 0 f mte Box) - Purpose of Building �� � Utility Authorization ExistingService 200 Amps Volts Overhead 0 Undgrd New Service 200 Amps Volts Overhead 0 Und rd r s g No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace exterior 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 Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool g boved. ❑ grnd. ❑ No.of Emergency Lighting rnBattery 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 Initiative Devices Total No.of Ranges No.of Air Cond. No.of Alerting Devices Ton 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 No.of Devices or Equivalent HeatersWater KW No.of No.of Ballasts Data Wiring: 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 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 (If applicable,enter"exempt"in the license number line.) LIC.NO.: 22314 Address: 156 CAPES TRL,WEST BARNSTABLE MA 02668 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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 thecheck one)) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $50.00 I -� r-RECEIVED MAY 18 E2 aa`` ��_ .. CommonwsaGth �Iaeearhiuestte ■. . °/ Official Use nl h B U i L t3 3 ;►i I cx P Permit No. k.,-2.2.-� �� ©v ie F s artmsni o f ira srvicse wzi BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked k (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),/7 CM 12.00 R K (PLEASE PRINT IN INK fR TYPE ALL INFORMATI<7N) Date: � City or Town of: YARMOUTH To the Inspec r of fres: By this application the undersigned gives notice/ of his or her intention to perform the electrical work described below. Location(Street&Number) sr/0, , Z/1-1 Owner or Tenant 6, - , N Owner's Address Telephone No. 7 AOY_ , jv_ Z Is this permit in conjunction with a building permit? Yes ❑ Purpose of Building NO (Check Appropriate Box) ':J Purpose Authorization No.__�zciet • Existing Service Amps /4__L'/ .. e,f aVolts Overhead Undgrd❑ No.of Meters ___2...- New Service � _ Amps 'a0/ OVolts Overhead �J/ Undgrd 0 No.of Meters ____L_Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: -7 ('' ‘rt -< .. �'f`r✓ /C- _' ita%tiiliX,ST% '-' -Z._ To o the ollowin:table m' be waived,,the In ector o Wires. t, p!` No.of Recessed Luminaires No.of Cell.-Susp. (Paddle)Fans Transformers ota o No.of Luminaire Outlets No.of Hot Tubs KVA Generators KVA ^'t' No. •of Luminaires Swimming Pool • ' ,ve ❑ n- 'o.o mergency g ng No.of Receptacle Outlets rod. nd. ❑ Butte Units No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.o t etec on an t No.of Ranges Initiatin. Devices No.of Air Cond. ota Tons No.of Alerting Devices `eat 'ump `um,er ons ' " `o.o e onta ne No.of Waste Disposers Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ ' uncepa nec No.of Dryers Heating Appliances KW ecu ty Cyst mstiton ❑ Othero.o "a er KW .° ° o.o No.of Devices or E,uivalent Heaters o ns Ballasts Data Wiring: No.Hydromassage Bathtubs Na of Devices or E uivalent No.of Motors Total HP a ecommun ca s ons " r .g: OTHER: No.of Devices or E,uivalent Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: (When required by municipalpolicy.) p INSURANCE COVERAGE: mess waived by ections to the owner,nopermit e requested in accordance the performance of electrical work maytissu the licensee provides proof of liability' u e including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove sin force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER I certify,under the pal . and pena/tie ., ,erfury,that the in❑formac'n opt thi plication is true and complete. FIRM NAME: D e../A„.)�- / ' �.,E op Licensee: s>r LIC.NO.: 1 c� Signature � (f applicable,enter"exem. "in the license number lin .�`_ s �""���._"--�— C.NO.: 9 Address: (p But.Tel.No.. � «°a�We, T r�� 1,: L S i 1� *Per M.G.L.c. 147,s.57-.1,security work requires Department of Public Safety"S"License: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By myLic.No. Owner/Agent signature below,I hereby waive this requirement. I am the(check one • owner Y Signatureowner's a:ent. Telephone No. PERMIT FEE:$ 50 ) C1,6-= CI t