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Home My WebLink AboutBLDE-22-006796 t • Commonwealth of Official Use Only �� Massachusetts Permit No. BLDE-22-006796 '`nob# 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:5/24/2022 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 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. 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: New family room 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- ElNo.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 Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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:$75.00 I eir. 4. I( 1'0- i ' Ftwei,e_ .?(24/-2. :E R. ECC IVED AY 2 3 2022 •nvsa[ih el///aodachudaifd Official Use Only n �7 Permit No. rz.,-z,--(07 CZL.0 t�� !4:NG DEPARTMENT ar�insnf° irs Serviced d.� ``!./,`J��:'= PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK N All work to be performed in accordance with the Massachusetts Electrical Code(MEC 7 MR 12.0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIQN) Date: _ City or Town of: YARMOUTH To the Inspecto of Wir By this application the undersigned gives notice of is or her intention to perform the electrical work described below. Location(Street&NuRyber) 99 Ay Arc NOwner or Tenant �6- Telephone No. ��' - Owner's Address ��f Is this permit in conjunction with a buitdi permit? Undgrd Purpose of Building Yes No ❑ (Check Appropriate Box) Utility A thorization No. Existing Service/CO Amps (d/ L�Volts Overhead Uod g El No.of Meters JNew Service Amps i / Volts Overhead Number of Feeders and Ampadty ❑ Undgrd 0 No.of Meters Location and Nature of Proposed Electrical Work: (ed,' /it,- Ay,_6(..„) AAA,.,./y jet t I) Completion of thefollowin&table may be waived by the Inspector of Wires. Niv 113 No.of Recessed Luminaires No.of Ceil.-Susp. No.of sp p (Paddle)Fans Total No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA ^t"' No.of Luminaires Swimming Pool Above In- No.of Emergency Lighting grnd. ❑ grnd. ❑ Battery Units R` No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and 't` No.of Ranges Initiating Devices No.of Mr Cond. l'otal Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Numb 1er Tons IVi'K No.of Self-Contained Totals:I"""'" Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW �❑ Municipal No.of Dryers Connection ❑ Other tY Heating Appliances KW Security Systems:* - No.of Water , No.of No.of Devices or Equivalent Heaters No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work toted Valart: (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 insu ncluding"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove s in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 I certify,under the ns and pens' of perjury,that the e u formation on this application is true and complete. FIRM NAME: ;4Jt- � 692-/e- i 7- a Licensee: C v LIC.NO.: .2`j 1 (If applicable,enter" xem `�� Signature IC.NO.: Address: P "in the h nse umber line.) Bus.Tel.No.. - �/Z:a *Per M.G.L.c. 147,s.57- 1,security work requires Department of Public Safe 5' License: Mt.Tel.No.: 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/Agent owner ■ owner's a:ent. Signature Telephone No. PERMIT FEE:$