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Home My WebLink AboutBLDE-22-005947 ' A Commonwealth of Official Use Only ' Massachusetts Permit No. BLDE-22-005947rel7 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:4/18/2022 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 orri ed be Location(Street&Number) 45 PINE CONE DR Owner or Tenant BROWN ELEANORE M Telepho o. Owner's Address C/O AUPERLEE ELEANORE M, BOX 487,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: Interior remodel&upgrade 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 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 ❑ 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:) 91). ez% - C 2_ I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. C� g C 06- FIRM NAME: Robert A Young '7 Licensee: Robert A Young Signature LIC.NO.: 10833 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:220 HIGH ST,REAR,TAUNTON MA 027803540 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: $125.00 Igo,, e,„,t/ s(dp plagf____ q/a/z Co rnrrwnweal°rh op lrlaiaac4 e etto i Official Use Only _ � 7 �7 l Ekis Ism ,,�" �;� Department G f.J`ire 5ervice9 I Permit No. ��j�/ S OF FIRE PREVENTION REGULATIONS [Rev. 1p0 Occupancy and Fee Checked �_. � BOARDI (leave blank) J APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be pertorned in accordance with the Massachusetts Electrical Code NEC), ''27 CMR !2.00 (PLEASE PRINT IN INK OR TYPE AL INFORMATION) Date: L-4( 1 t 1 e?C,f,;2 f--1 City or Town of: (A)t O,_ V1' 1 V will To the Inspector of Wires: By this application the undersigned gives notice of his or her intentionn to perform the electrical work described below. Location(Street&Number) �j A' e C as - .M Owner or Tenant Telephone No. � Owner's Address Is this permit in conjunction with a building permit? Yes No (Check Appropriate Box) Purpose of Building ")'}1C Utility Authorization No. Existing Service Amps i Volts Overhead Undgrd No.of Meters New Service Amps - T_ -_ Volts Overhead___, Undgrd 7 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Won ,cj y\1C- (,&P/'Y7A 1 ,cx h Iv)'1G Vrriv -- Completion of the following table may be waived by the Inspector of Wires. jNo.of Recessed Luminaires lNo.of Ceil:Susp.(Paddle)Fans No.of Total l Transformers KVA l 1No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Batters Units _ .. _ 5 _� jNo.of Receptacle Outlets INo.of Oil Burners )FIRE ALARMS INo.of Zones i 'No.of Switches No.of Gas Burners No.of Detection and t Initiating Devices Total !No.of Ranges No.of Air Cond. Tons 'No.of Alerting Devices { 1 Heat Pump Number Tons KW._ ...;No.of Self-Contained r lNo.of Waste Disposers 1 Totals: Detection!Alertinc Devices INo.of Dishwashers Space/Area Heating KW Local❑ 4luntctpal ❑ Other Connection No.of Dryers Heating Appliances Security yystems:* i• g- PP ' Na.of Devices or E,uivalent!No.of Water No.of i o.o Heaters Sians Ballasts Data Wiring; No.of Devices or E,uivalent ( , Telecommunications =• firing: N+o.Hydromassage Bathtubs I No.of Motors Total HP No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Works, - ) `-- (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 coverage is in force,and has exhibited proof of same to the permit issuing office, CHECK ONE: INSURANCE 2BOND ❑ OTHER ❑ (Specify:)1, t el..�I Li-y C ,. .k:. Iia/ I certify, under the pains and penalties ofperjuty,that the information on this applicatidtt is true and comp. . 1 9 FIRM NAME:Young Electrical Svc. Inc. LIC.NO.:A10833 Licensee: Robert A. 4 oung Signatu ✓` r,^ LAC.NO,:E24869 (If applicable,enter"exempt"in the license number line.) t l us.Tel ;No;508-823-0279 Address: 220 High Street(Rear)Taunton, MA 02780 �-Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. SSCO-0092 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. I am the(check one)E owner ❑owner's agent. Owner;Agent Signature Telephone No. PER: IT FEE: $ i jt( i7