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Home My WebLink AboutBLDE-22-006463 or Commonwealth of Official Use Only E Massachusetts Permit No. BLDE-22-006463 F " ` BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:5/10/2022 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) 99 BERRY AVE Owner or Tenant James Fochler Telephone No. Owner's Address 99 BERRY AVE,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes ❑ No 0 ,' 80z)eMCI R,creel l Purpose of Building Utility Authorization e ' , , r f Existing Service 100 Amps Volts Overhead 0 Undgrd 0 r • 1 " 71Li New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement panel. 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 Eauivalent 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 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 gee.: - • RECEIVED 5' AY o 9 2021Co ealt/t el�Jaaaachusetie Official Use Only `J '1t isptmenE Permit No, ` OA u yr r E -REVENTION REGULATIONS Occupancy and Fee Checked ` (Rev. Vim (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M ),527 MR 12.00 Z (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: YARMOUTH To the Ins ect of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 99 /3 j T� iv Owner or Tenant J ,,y,,� e. �l Owner's Address / A �� `� rvit/ Telephone No. 7%-yg y yG Is this permit in conjunction with a building permit? Yes No Purpose of Building_�j �� 0 (Check Appropriate Box) 2 Utility Authorization No. jy,5-s38'6 Existing Service /OG Amps rda /)yei Volts Overhead Ef".--- Undgrd 1; ❑ No.of Meters _ New Service Amps / Undgrd❑ g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work:Volts Overhead A l'l, •l. n, VI U Completion of the followingtable m be waived by the Inspector of Wires. U. No.of Recessed Luminaires No.of Ceil.-Sas . No.of- Total Uap (Paddle)Fans Transformers No.of Luminaire Outlets KVA _ No.of Hot Tubs Generators KVA t; 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 t No.of Ranges Initiating Devices g No.of Mr Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number 1 Tons KW No.of Self=Contained Totals:I Detection/Alerting_Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other• No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters ' Data WIring: No.of Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires, Estimated Value of Electrical Work: Work to Start: (When required by municipal policy.) 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 insuran 'ncluding"completed operation"coverage or its substantial equivalent. The undersigned certifies that such covers ' ' force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify,under the ins and penalties of perjury,that th nformation on this application is true and complete. FIRM NAME: ies.�J' - EL/° /L A,i Licensee: /�ie .�z � _ LIC.NO.: a�31 (If l/�ti2� Signature C��jf `� LIC.NO.: 379g Liapplicable,enter"exem t"in th tense number line.) -�� Address: /� cede 7Z4 rZ UI PS7 84 s is iAlL Tel.No.. `'1 y�� *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: AIt.Lic.No. Tel. � OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n — required by law. By my signature below,I hereby waive this requirement. I am the(check one ■ owner ■ owner's a ent. Owner/Agent Signature Telephone No. p PERMIT FEE:$